Term
What is the name of Broken Heart Syndrome? x2
What is the presentation of the disease and treatment |
|
Definition
Tako-Tsubo cardiomyopathy
Transient apical ballooning syndrome
Post menopausal woman hears bad news.
Has a Myocardial Infarction.
Ballooing and left ventricular dyskinesis
Manage as if MI but Coronary angiography is negative |
|
|
Term
What Constitutes a family history of CAD? x 2 answers
What are the normal values for Total Cholesterol, LDL's, HDL's ? |
|
Definition
1. First degree Family... not grand parents.
2. Premature CAD in family- male <55 - Female <65
Total Cholesterol <200
LDL <100
HDL <30 |
|
|
Term
What are the Major Risk factors For CAD? x 6
What is the worst risk factor
and the most common? |
|
Definition
DM (worst)
tobacco
HTN (most common)
Hyperlipidemia
Premature CAD Fx
Primary family |
|
|
Term
What are the 3 main diagnostic criteria for MI vs NOT?
what is the most likely character of the pain? |
|
Definition
No change in position
No change in respiration
No change in touch
Dull sore
Squeezing (Levan's sighn) |
|
|
Term
What is the dx:
1)Radiating to back
what will be found with this? |
|
Definition
Aortic Dissection
unequal blood pressure |
|
|
Term
What is the diagnosis:
Pain worse with lying flat, better when sitting up. <40
What is the MAT? |
|
Definition
Pericarditis
EKG: showing ST elevation and PR depression sporaticaly |
|
|
Term
most likley dx?
Epigastric discomfort better when eating
MAT? |
|
Definition
|
|
Term
most likley dx?
Epigastric discomfort better when eating
MAT? |
|
Definition
|
|
Term
MLD?
Bad taste, cough, hoarseness
MAT? |
|
Definition
|
|
Term
What is the MAT for pneumonia?
What is the MLD?
sudden-onset SOB, tachycardia, hypoxia,?
MAT? |
|
Definition
Chest xray
Pulmonary Embolus
Spiral CT, V/Q scan |
|
|
Term
what has sharp, Pleuritic pain, tracheal deviation?
What is the MAT |
|
Definition
|
|
Term
what is the equation for Max HR?
What medications should be withheld before a stress test? |
|
Definition
220 - age of pt = max HR
AntiIschemics, Digoxin, B blockers. |
|
|
Term
What are the drugs that lower mortality for pt with Angina
What are some other medications used and why are they used? |
|
Definition
Aspirin
B blockers
Nitro
Clopidogrel (allergy to Asprin)
Ticlopidine (allergy to Asprin and Clopigrodel
ACEi Lower ejection fraction decreases systolic dysfuntion./regurgitant valve.
Prasugrel (stenting or angioplasty) |
|
|
Term
what is the most common Adverse effect of Statins
What is the other one you should worry about? |
|
Definition
Liver dysfunction ( check AST ALT routinely )
Myositis ( Check CPK only as needed ) |
|
|
Term
What drug increased mortality in patients with CAD?
when should they be used for CAD? x3 |
|
Definition
Ca Channel Blockers
When Severe asthma limits the use of b blockers
Prinzmental variant angina,
Cocaine induced chest pain |
|
|
Term
What is a Machinery Murmur ass with?
What is a displased PMI ass with?
What is a S4 gallop ass with? |
|
Definition
ductus arteriosus
LVH
Stiff left ventrical |
|
|
Term
|
Definition
|
|
Term
When do these cardiac Enzymes become abnormal and stop?
Myoglobin
CK-MB
Troponin
When will there be no Enzymes? |
|
Definition
Myoglobin: 1-4 hours to 1-2 days
CK-MB: 4-6 hours to 1-2 days
4-6 hours to 10-14 days
less than 1 hour from onset
and 2 weeks after |
|
|
Term
When should PCI be used?
Why should it be used?
When is it not used? |
|
Definition
within 90 min of MI
bc it increases moratlity and decreases chance of MI complications
In rural area without the basic requirements. |
|
|
Term
| What are is CI of TPA? x4 |
|
Definition
Major Bleeding ( melena or brain)
Resent surgery
>180/100 b/p
stroke within the last 6 mo. |
|
|
Term
what is a "N steppy"
what extra medication should be given for a N-steppy?
What does it do what does it not do? |
|
Definition
a type of angina that has ST depreesion on leads.
Heparin
it stops new clots from forming
does not get red of clots already formed |
|
|
Term
| When should Glycoprotein IIb/IIIa inhibitors be used in MIs ? |
|
Definition
pts who are to undergo angioplasty and stenting
and non st elevation MIs/unstable angina |
|
|
Term
name the MI complications that cause Bradycardia.
and there distinguishing feature. |
|
Definition
3rd degree AV block
-Brady + Cannon A waves
-these are bounding jugulovenous wave bounding up into neck.
Sinus bradycardia
- No Cannon A. |
|
|
Term
| what is the treatment for a Right ventricular infaction as a complication of MI? |
|
Definition
40% of inferior wall myocardial infarcts will have a right vent infarct.
High volume replacement and avoid nitroglycerin. |
|
|
Term
What is Cardiac Temponade?
What are the S&S?
how do you diagnose and treat it? |
|
Definition
Compression of the heart due to fluids in the pericardial space ( in the case of MI it is a ruptured wall that leaks blood) this leak of blood leads to decreased heart funtion
several days after infarct a 'sudden loss of pulse'
Paricardiocentesis |
|
|
Term
| what are the 8 main complications of post MI? |
|
Definition
3rd degree AV block
Sinus Bradycardia
Tamponade/ wall rupture
RV infarct
Valve rupture
Ventricular fib.
Ventricular tachy |
|
|
Term
when pt is asymptomatic what is the first step to discharge? what if that is negative?
What are the routine discharge medications?
what do you not give for discharge |
|
Definition
Stress test
Angioplasty
Aspirin
Beta blockers
Statins
ACEi
Dont use antiarrhythmics
they increase mortality |
|
|
