Week 206 - Myocardial Infarction Flashcards
Which leads look at the Inferior Part of the Heart?
II, III and aVf
Which leads look at the Anterior Part of the Heart?
V2, V3, V4
Which leads look at the Lateral Part of the Heart?
I, aVL, V5, V6
Which leads look at the Posterior Part of the Heart?
V1, aVR
What artery is involved if an ANTERIOR infarct is seen?
LAD (Left anterior descending artery)
What artery is involved if an INFERIOR infarct is seen?
RCA (Right Coronary Artery)
What artery is involved if an LATERAL infarct is seen?
Circumflex
What artery is involved if an POSTERIOR infarct is seen?
Circumflex
What ECG changes would indicate hypokalaemia?
U waves (V2, V3) T wave depression
What is a J wave indicative of?
Hypothermia
What do you get in Digoxin toxicity?
Bradycardia Prolonged PR interval Frequent premature beats Nausea, Vomiting, Abdo pain, headache, delirium
What do chylomicrons do?
Carry fats from intestine and release in liver
What LDL is present in HEALTHY individuals?
Few LARGE LDL
What LDL is present in Atheromatous disease?
Lots SMALL dense LDL
What is the ideal cholesterol level in the blood?
<5 mmol/L
What is the action of Aspirin?
Anti-platelet action via irreversible acetylation of COX-1
What enzyme converts arachadonic acid into eicosanoids? (e.g. prostaglandins, TXA2)
COX-1 and -2
What is the function of Thromboxane A2?
Released by platelets Vasoconstrictor + Platelet agonist
What clinical features would you expect to find in a patient with FH?
Tendon Xanthomata (virtually diagnostic of FH) - mobile nodules on tendons Corneal arcus
What can raised troponin indicate?
?MI ?PE ?Septicaemia ?Renal Failure ?Myocarditis ?Trauma
What ECG changes would suggest MI?
ST elevation New LBBB Pathological Q waves
What does Fondaparinux do?
Anti-coagulant Inhibits Factor Xa
What do Clopidogrel, prasugrel and ticagrelor do?
Anti-platelet Act on ADP receptor –> prevents activation of platelets Clopidogrel activated by P450 (loss of function allele possible)
What is the most common mode of death <12 hrs after MI?
Arrhythmic Death
What can be used to assess the risk of MI?
GRACE TIMI
What action do steroids have?
Inhibit PL-A2 -> inhibit inflammatory mediators
What function do Abciximab, Eptifibatide, Tirofiban have?
Glycoprotein IIB-IIIA Antagonists
In large pericardial effusions, what structures can become compressed?
Oesophagus-> Dysphagia Recurrent Laryngeal-> Hoarseness Diaphragmatic stimulation (hiccups)
What are the signs of Cardiac Tamponade?
Tachycardia Hypotension Rales/Oedema/Ascites Muffled heart sounds Pulsus Paradoxus
What does the a wave signify?
Atrial Contration
if AF no a waves
What does the c wave signify?
Tricuspid closure
What happens during the x descent?
Atria relax
What happens during the v wave?
RA filling
What happens during the y descent?
Tricuspid valve opens
What dermatomes innervate the pericardium (sensory)?
C3-C5
