Wk1: ACS, MI, cardiac issues

Question 1

Differentiate between acute and chronic pericarditis.

Question 2

what is the beck of triad?
When does it occur?

Answer 2

1. hypotension (d/t decreased CO)
2. JVD (d/t blood back flow)
3. muffled heart sounds (d/t fluid buildup)

-occurs with cardiac tamponade

Question 3

What is pulsus paradoxus?

Answer 3

happens in 70-80% of cardiac tamponade Pts

decreased systolic blood pressure of 10mm Hg or more with inspiration

**easier to see with Arterial line placement

Question 4

typical manifestations of acute pericarditis.

Answer 4

-CP (sharp and worsens with deep breath)
-fever
-dyspnea
-pericardial friction rub: scratching sound heard
-ST elevations on EKG

Question 5

Tx for pericarditis

Answer 5

NSAIDs
ASA
corticosteroids
Colchicine (if NSAIDs don’t work)

Question 6

pericardial effusion

Answer 6

the fluid accumulated in the pericardial space, surrounding the heart

Question 7

cardiac tamponade

Answer 7

> 200mLof fluid accumulation
-compressing the heart
-changes ability of heart to pump accurately
-cannot stretch and fill with blood

Question 8

etiologies/pathogenesis of aortic aneurysms

Answer 8

-changes occur in vessel (d/t HTN)
-vessel wall gets thicker
-vessel starts to burst, causing abnormalities
-aneurysms cause turbulent blood flow & are susceptible to rupture

Question 9

etiology/pathogenesis of aortic dissection

Answer 9

blood gets between layers of the vessels and it rips layers apart

Question 10

what is the most common location for a berry aneurysm?

Answer 10

circle of Willis
-most common bifurcation location, located between anterior and posterior circulation at base of brain
-deadly with rupture

Question 11

pseudo-aneurysm:

Answer 11

localized dissection in inner artery wall
-type of hematoma
-complication of vascular interventional procedure

Question 12

Differentiate between the various types of aneurysms, including saccular, berry, and
fusiform.

Answer 12

saccular: wide neck with ball on top, only on one side of the artery
Berry: subtype of saccular, small neck, located at bifurcation
fusiform: surrounds entire artery, gradually progressive dilation

Question 13

Describe LaPlace Law

Question 14

Differentiate between true and false aneurysms.

Question 15

clinical manifestations of abdominal aortic aneurysm

Answer 15

bruit
pulsatile mass

Question 16

clinical manifestations of TA

Question 17

characteristics of unstable plaque

Question 18

pathophysiologic theory of plaque rupture

Question 19

Describe the most important serum cardiac marker, including its significance, and when it can be
measured.

Question 20

difference between cardiac ischemia and cardiac infarction

Question 21

when does an irreversible injury occurs.

Question 22

Differentiate between stable angina and acute coronary syndrome
-Definitions
-Pathogenesis
-common characteristics ?

Question 23

Reason unstable angina and acute MI have been grouped together as ACS

Question 24

Differentiate between unstable angina and acute myocardial infarction, including aspects of
occlusion and thrombus, ECG changes, and cardiac enzyme changes

Question 25

Tell the differences between STEMI and NSTEMI, including: ST segment, Troponin, size of infarct, and patient outcomes.

Question 26

Discuss the immediate pharmacotherapy treatment of STEMI, including fibrinolytic therapy.

Question 27

the drugs a patient should take long-term s/p a STEMI.