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Year 3 MedEd > Cardio1 > Flashcards

Cardio1 Flashcards

Chest Pain (67 cards)

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1
Q

What is the definition for a stable angina pectoris?

A

Chest pain upon exertion due to ischaemia, which is alleviated by rest

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2
Q

What are the causes of a stable angina pectoris?

A

Atherosclerotic plaque
Decubitus angina
Prinzmetal angina
Coronary syndrome X

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3
Q

What is decubitus angina?

A

Symptoms upon lying down

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4
Q

What is Prinzmetal angina?

A

Symptoms due to coronary vasospasm

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5
Q

what is coronary syndome X?

A

Symptoms of an angina but with normal exercise tolerance and normal coronary angiograms.

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6
Q

What are the conservative management options for stable anginas?

A

Exercise
Diet
Weight loss
Stop smoking

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7
Q

What are the medical management options for stable anginas?

A

Symptomatic (GTN spray)
Anti-anginal (BB/CCB)
Risk factor reduction (statin/ACEi/aspirin)

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8
Q

What are the three pathologies categorised under acute coronary syndrome?

A

STEMI
NSTEMI
Unstable angina

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9
Q

What is a STEMI?

A

ST elevated myocardial infarction

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10
Q

What is a NSTEMI?

A

Non-ST elevated myocardial infarction

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11
Q

What is an unstable angina pectoris?

A

Chest pain at rest due to ischaemia

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12
Q

What is the first investigation to do on a Pt with central, crushing chest pain, radiating to the jaw, and what are you looking for?

A

ECG

ST elevation

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13
Q

What would you do if there was no ST elevation in the ECG and what would each finding signify?

A

Troponin levels
Troponin +ve: NSTEMI
Troponin -ve: unstable angina pectoris

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14
Q

Which cohort of Pt’s could present with silent MI’s?

A

Elderly

Diabetics

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15
Q

What can you see in an ECG in a Pt with a STEMI?

A

ST elevation
Hyper-acute T waves
New onset LBBB

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16
Q

What can you see in an ECG in a Pt with an NSTEMI/UAP?

A

ST depression

T wave inversion

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17
Q

What do pathological Q waves suggest?

A

History of an MI

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18
Q

Which leads would have ST elevation in an anterior MI and which coronary artery is affected?

A

V1-V4

Left anterior descending

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19
Q

Which leads would have ST elevation in an lateral MI and which coronary artery is affected?

A

I, aVL, V5-6

Left circumflex

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20
Q

Which leads would have ST elevation in an inferior MI and which coronary artery is affected?

A

II, III, aVF

Right coronary artery

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21
Q

Which leads would have ECG changes in an posterior MI and which coronary artery is affected?

A

Tall R waves and ST depression in V1-3

Posterior descending

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22
Q

What is the acronym for ACS management and what do they stand for?

A 
MONABASH
Morphine
Oxygen
Nitrates (GTN)
Anti-platelet (asipirin, clopidogrel)
Beta-blocker
ACEi
Statin
Heparin
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23
Q

What are the aims of treatment for a STEMI?

A

Coronary reperfusion

By PCI or fibrinolysis

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24
Q

If a Pt presents <12hrs after the onset of symptoms how should you manage them?

A

Send to the cathlab for PCI if it can happen <120min of the time that fibrinolysis could have been administered

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25
If a Pt presents >12hrs after the onset of symptoms how should you manage them?
Coronary angiography then PCI if indicated
26
How should you treat a Pt with a NSTEMI/UAP?
Aspirin + another antiplatelet (clopidogrel/ticagrelor) Fondaparinux if low risk of bleeding and not scheduled for coronary angiography within 24hrs LMWH if coronary angiography planned
27
What should you use to stratify a patient's risk of mortality from an ACS?
GRACE score
28
What should you do to a patient with a high risk GRACE score?
``` Give a GlpIIb/IIIa inhibitor (tirofiban) Coronary angiography (<72hrs) ```
29
What should you do to a patient with a low risk GRACE score?
Conservative management | control the risk factors
30
What are the complications of ACS?
``` DARTH VADER Death Arrhythmia Rupture Tamponade Heart failure Valve disease Aneurysm Dressler's Syndrome Embolism Re-infarction ```
31
What is pericarditis?
Inflammation of the pericardium
32
What are the causes of pericarditis?
``` Idiopathic Infective (eg. Coxsakie B) Connective tissue disease (eg. sarcoidosis) Dressler's Syndrome (2-10 wks post-MI) Malignancy ```
33
What are the symptoms and signs of pericarditis?
``` Sharp, central stabbing pain Pleuritic Relieved by sitting forward Fever/flu-like (if viral) Pericardial friction rub Tamponade (if pericardial effusion) ```
34
What investigations would you perform on a Pt with pericarditis?
ECG Bloods (CRP, ESR) CXR
35
What would you see on an ECG in a Pt with pericarditis?
Widespread saddle-shaped ST elevation
36
What is atrial fibrillation?
Chaotic, and ineffective contraction of the atria
37
What are some causes of AF?
``` Lots Pneumonia PE Hyperthyroidism IHD Alcohol Pericarditis ```
38
What are the symptoms and signs of AF?
Dizziness Palpitations Symptoms of underlying cause Irregularly irregular pulse
39
What investigations would you perform on a Pt with AF?
ECG | Investigations for the underlying cause
40
What would you see on an ECG in a Pt with AF?
Irregularly irregular tachycardia with absent P waves
41
What should you do to a Pt with AF who is haemodynamically unstable?
DC cardioversion
42
What means of rhythm control should you give a Pt with an onset of AF <48hrs?
DC cardioversion or Chemical cardioversion (flecainide/amiodarone) [Flecainide is contra-indicated if IHD Hx]
43
What means of rhythm control should you give a Pt with an onset of AF >48hrs?
Anticoagulate for 3-4 weeks before cardioversion
44
What means of rate control should you give a Pt with AF?
Verapamil Beta-blockers Digoxin
45
What score is used to calculate the risk of stroke in AF patients?
CHA2DS2VASc
46
What should you give a Pt with a low CHADSVASc score?
Aspirin/nothing
47
What should you give a Pt with a high CHADSVASc score?
Warfarin (and heparin)
48
What does a supraventricular tachycardia look like on an ECG?
A regular narrow-complex tachycardia with no P waves
49
What are the symptoms of an SVT?
Syncope Palpitations Dyspnoea Chest discomfort
50
What is AVNRT?
A local circuit forms in the AV node
51
What is AVRT?
A re-entry circuit forms between the atria and ventricles via an accessory pathway (Bundle of Kent)
52
What would an ECG show after the termination of an AVNRT?
No abnormalities
53
What would an ECG show after the termination of an AVRT?
``` Delta waves (slurred QRS upstroke) Wolff-Parkinson-White Syndrome ```
54
What should you do to treat a Pt with an SVT and is haemodynamically unstable?
DC cardioversion
55
What should you first do to treat a Pt with an SVT and is haemodynamically stable?
Valsalva manouvres
56
What should you first do to treat a Pt with an SVT and Valsalva manouvres failed to succeed?
IV adenosine 6mg IV adenosine 12mg (if failed) IV adenosine 12mg (if failed again)
57
What should you first do to treat a Pt with an SVT and IV adenosine failed to succeed?
``` One of: IV B-blocker (metoprolol) IV amiodarone IV digoxin DC cardioversion ```
58
What condition contraindicates the use of adenosine and what should you use as a substitute?
Asthma | Verapamil
59
What is syncope?
Loss of consciousness due to a lack of perfusion to the brain
60
What are the causes of syncope?
``` VAOP Vasovagal Arrhythmia Obstructive Postural hypotension ```
61
What is the pathophysiology of a vasovagal collapse and what are some symptoms?
Increased vagal activity (eg. sight of blood) | Sweating/pale
62
What is the pathophysiology of an arrhythmia collapse and what are some symptoms?
Reduced cardiac output | Palpitations
63
What are some causes of an obstructive collapse?
Hypertrophic obstructive cardiomyopathy | Aortic stenosis
64
What are the typical findings of someone with HOCM?
Jerky carotid pulse Double apex beat Ejection systolic murmur FHx of sudden death <65yrs
65
What is the pathophysiology of a postural collapse and what are some causes?
Lack of compensation for the hypotension that occurs upon standing Medications (anti-hypertensives) Dehydration
66
What are some non-syncopal causes of collapse?
Intoxication Head trauma Metabolic (eg. hypoglycaemia) Epileptic seizure
67
What would you give a Pt with hyperkalaemia?
10ml 10% calcium gluconate

Year 3 MedEd (29 decks)

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