Cardiology Flashcards
(44 cards)
What is the dose of aspirin and ticagrelor given during an M.I?
Aspirin 300mg
Ticagrelor 180mg
STAT
What are the cautions for ticagrelor?
Asthma
COPD
Bradycardia
What are some cardiac and non cardiac causes of elevated BNPs?
Cardiac:
- Heart failure
- ACS
- Myocarditis
Non- cardiac:
- advance age
- ischemic stroke
- SAH
- COPD
- Burns
In an echocardiogram for heart failure, what are you looking for?
LV systolic function - ejection fracture
LV dimision
Valvular abnormalities
Diastolic function
What are the levels of ejection fracture?
Normal >55%
Mild 45-55%
Moderate 36-44%
Severe <35%
What signs may be seen on ultrasound of a P.E?
RV dilation
RV hypokinesis
Pulmonary hypertension
What murmur may be heard with aortic dissection?
Aortic regurgitation
- due to widen of the aortic outlet causing back flow.
intussusception may occur
What are the indications for CABG?
> 50% stenosis of the main left artery “critical main left stem disease”
2-3 Artery involvement “triple disease”
Poor ventricular function associated with multi-vessel disease
When a patient is put on cardiopulmonary bypass - what must they be given and then what follows this?
Heparin to avoid clots within the machine.
this is revered with protamine once the blood returns to the patient.
*blood is drained via the great veins, either IVC or SVC and returned directly into the aorta
What drug is given to stop the heart during a cardiopulmonary bypass?
Cardioplegia
- high K+ load.
doesn’t cause ischemia
What is the procedure of choice for aortic stenosis, and what is the alternative for those who are not fit for surgery?
Aortic valve replacement is treatment of choice.
TAVI is the option for those who are unfit for surgery.
Contrast the differences between mechanical and tissue AVRs
mAVR:
- lifelong
- Durable
- requires anticoagulation
- clicks
- haemolysis
tAVR:
- 10-15years
- non-durable
- doesn’t require anticoagulation
- non-audible
- vegetations grow
What are the indications for a mitral valve replacement?
Severe MR
Severe symptoms
Papillary muscle rupture - usually post M.I
When would you only control the rate in someone with AF?
Structurally abnormal heart
> 65 years old
Persistent AF
Hypertension
Previously failed treatment
Less symptomatic
What type of aortic dissection will have a weak/ absent radial pulse? and what is the management?
Stanford type B
- it is distal to subclavian
- Medical management
- to control BP
What are the indications for surgery in aortic dissection?
Type A
Persistent pain
Failure of medical management
Aortic rupture
What conditions are associatted with VSD?
Down’s syndrome
Edwards syndrome
Patau’s syndrome
What is the most common congenital heart disease, and what syndrome is it highly associated with?
Bicuspid Aortic valve
Turner’s syndrome
What heart murmur would you expect to hear with coarctation of the aorta?
Systolic murmur in between the shoulder blades, usually nearer the left
Harsh systolic ejection over the left side
What are some of the systemic outcomes of Eisenmenger’s syndrome?
Increased erythrocytes
- increased blood viscosity and clots
Damaged endothelium due to high pressure
- increased bleeding and poor platelet activation
Gout
Acne
What are some of the systemic signs of Eisenmenger’s syndrome?
Dyspnea
Syncope
Cyanosis
Finger clubbing
Right ventricular heave
List some conditions where pregnancy is contraindicated:
Primary pulmonary hypertension
- carries a mortality of 30-50%
Marfan’s syndrome with dilated aortic root
Severe aortic stenosis
Severe mitral stenosis
Severe LVSD
What congenital heart disease is associated with berry aneurysms?
coarctation of the aorta
What vessels maybe used in bypass graft?
venous
- great saphenous vein
Arterial
-left internal mammary artery
