Week 2 Flashcards
symptoms of angina (5)
chest pain
referred pain
dyspnoea
sweating
fatigue
syncope
mech of dyspnoea in cardiac issues (MI, HF, ischaemia) 4 steps
1.reduced cardiac ouput
2. increased pulmonary pressure
3. interstitial oedema and pulmonary congestion
4. gas exchange impairment
what are the nerves involved in referred pain in MI
cardiac visceral spinal afferents
reason for referred pain
the cardiac visceral spinal afferents converge with sensory nerves from chest and upper limbs at the same spinal nerves hence referred pain
what are the key spinal nerves from which referred pain is derived from
c3-T5
aortic dissection pain 2 characteristics
tearing pain
radiates to back and shoulder
pericarditis 2 characteristics
sharp
worse upon deep breathing
pulmonary embolism 3 characteristics
pleuritic pain: sharp, stabbing
worse uppon inspiration
radiation to back and shoulder
pneumothorax pain 2 charateristics
pleuritic pain: sharp, stabbing
worse upon inspiration
GORD pain 2 characteristics
burning central pain
worse after eating and lying down
ECG findings for unstable angina and NSTEMI (2)
ST depression, T wave inversion
what other conditions cause high troponin 7
pericarditis
myocarditis
physical activity
stroke
sepsis
trauma
pulmonary embolism
what are the two key troponins
I and T
TIMI score (7 criteria)
risk assessment for unstable angina and NSTEMI
age>65
Aspirin
Prior stenosis
ST depression
Cardiac markers
>3risk factors
Angina
ED presentation for STEMI process 5
insert cannula
aspirin
analgesic
ECG every 10min
establish reperfusion method
discharge after ACS 6
dual antiplatelet (aspirin+ticagrelor)
ACE inhibitor
Beta blocker
High intensity statin
Cardiac rehab
Other risk factor management
type 1 MI
due to plaque rupture or erosion
type 2 MI
due to oxygen supply demand mismatch
type 3 mi
sudden cardiac death without elevated biomarkers
type 4 MI
death during PCI
type 5 MI
death during cardiac surgery
causes of type 2 (think groups then examples of each)
Oxygen delivery: RF, PE, pneumothorax
Heart rate: tacchycardia
BP: severe hypertension, hypotension
Coronary: vasospasm, endothelial dysfunction, dissection
causes of vasospasm 3
smoking
drugs
endothelial dysfunction
symptoms of coronary artery spasm
same as mi: dyspnoea, tachycardia, syncope, referred pain, chest pain
benefits of fibre in reducing coronary artery risk 2
- absorb cholesterol allowing more excretion than absorption
- reduce rate of sugar absorption important in diabetes management which is major risk factor of CAD
benefits of plant sterols and stanols
similar structure to cholesterol hence compete for absorption, reducing cholesterol absorption
DASH diet
dietary approaches to stopping hypertension
includes low salts
signs of PAD 2 generic
asymptomatic
intermittent claudication
severe signs of PAD progression
palor
pulselessness
cold
parasthesia
paralysis
pain
beurger’s sign
gangrene
ulcerations
charcots foot
symptoms of stroke 6
hemiparesis
confusion aka dysarthia
dysphasia
syncope
unilateral vision loss
hemi-negligence
where does cerebrovascular atherosclerosis most commonly occur
in carotids, specifically the bifurcation between common to internals
PAD management
pharmacological: dual antiplatelet, statins, ACE (to control BP)
Bypass
Stenting
CBV management
Gold standard: Carotid artery endoarterectomy if stenosis >50%
carotid stenting
pharmacological: statins, dual antiplatelet, ACE
ethics of tolerance
Acceptance of other beliefs even if they do not align with one’s as long as they do not cause harm
AFIB signs on ECg
irregular irregular rate and rhythm
absence of p waves
