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ICM Exam 3 Cardiology > Acute Ischemic Heart Disease - Yaacoub > Flashcards

Acute Ischemic Heart Disease - Yaacoub Flashcards

1
Q

ASA contraindicated in

A

severe aspirin allergy

Implement desensitization

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2
Q

NonSTEMI can also be associated with

A

normal ECG

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3
Q

Preferred clopidogrel strategy

A

Pretreatment

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4
Q

29% reduction in death/MI in PCI patients

A

Clopidogrel Tx

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5
Q

RV infarction

A

HoTN

JVD

Clear lungs

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6
Q

Most important criteria in TIMI risk score

A

Age >65

>3 risk factors for CAD
ST changes

Prior coronary stenosis

> 2 anginal episodes in the past day

Elevated cardiac markers

Use of ASA within 7 days

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7
Q

RRR (relative risk reduction) of ____ with early invasive intervention

A

49%

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8
Q

In first 24 hours, __ STEMI patients and __ NSTEMI patients

A

26%

14%

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9
Q

4 Highest reductions in mortality

A
  1. Heparin, ASA
  2. BB
  3. Cath
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10
Q

Nitrates contraindicated in patients with

A

RV infarction

PDE inhibitors

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11
Q

Relative risk of death in ST changes

A

T wave inv = 62%

STE= 68%

STD = 2.27

**ST depression is the worst prognostic marker

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12
Q

___ has higher bleeding complications and lower combined endpoints of death/MI/revascularization

A

Prasugrel

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13
Q

Low risk ACS

A

New-onset or progressive CCS class 3 or 4

Normal or unchanged ECG during chest discomfort

Normal cardiac markers

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14
Q

Avoid BB with

A

intrinsic sympatholytic activity

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15
Q

Global diffuse ST changes without reciprocation

A

pericarditis

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16
Q

Which risk is higher, No troponin and CAD, or +troponin and no CAD

A

No troponin and CAD

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17
Q

May use __ as substitute for ASA

A

clopidogrel

18
Q

abciximab + heparin is most beneficial for patients with

A

troponin elevation

(vs. just heparin)

19
Q

Score 6/7 is the greatest risk, at ___%

A

41%

20
Q

Use 2b3a in whom

A

those who are at higher risk

benefit most profound with stented diabetics

21
Q

Intermed risk patients for ACS

A

Prior MI, PVD, or CABG

Prolonged rest angina now resolved

Rest angina under 20 min

Age above 70

T wave inversions >.2mV

Pathological Q waves

Slightly elevated cardiac markers

22
Q

Risk stratification based on

A

TIMI risk score

23
Q

Everyone with Stent and most with PCI get

A

DAPT

24
Q

Acute anterior wall MI is what vessel

A

LAD

25
Q

Reduces mortality by approximately 50%

A

ASA

26
Q

In-hospital early interventions

A

Early Diabetes control

Eary ________ control

27
Q

High risk in ACS

A
  • Accelerating ischmic Sx
  • >20 min rest pain
  • Pulm Edema
  • MR murmur (new or worse)
  • S3
  • New/worse rales
  • HoTN
  • Age >75
  • ST changes >.05mV
28
Q

ST depression or T wave inversion means either

A

Unstable angina or NSTEMI

29
Q

Pathophys of ACS

A

Plaque rupture

Blood clot

Blding into plaque accompanies rupture

30
Q

Angina pectoris definition

A

acute ischemic chest pain

with either res pain or a crecendo pattern of pain on minimal exertion

associated with ECG changes of ischemia

31
Q

Can have a completely normal ECG with ____

A

significant disease of the circumflex artery

32
Q

2b3a is given over what time period

A

12-16 hrs

33
Q

CI’s for beta blockers

A
  • HoTN
  • Severe bronchospasm
  • Bradycardia (heart block)
  • Suspected Prinzmetal or cocaine (spasm)
34
Q

additional _____ reduction in use of LMWH vs ___

A

12%

Unfractionated

35
Q

Continue plavix for

A

one year or longer

36
Q

ST segment elevation in aVR is marker for

A

Left Main coronary disease

37
Q

2b3a inhibitors reserved for

A

patients in or going to cath lab

prevents platelet aggregation via 2b3a antagonism

38
Q

Deep and symmetrical T wave inversion (that is usually global) in multiple leads, accompanied with headace

A

Intracranial hemorrhage

39
Q

9% reduction in death/MI at 30 days

A

gp2b3a inhibitors

40
Q

Invasive prrefered with:

A
  • Recurrent Ischemia
  • CHF
  • Cardiogenic shock
  • Hx of PCI in the past 6 months
  • Previous CABG

ICM Exam 3 Cardiology (8 decks)

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