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Flashcards in Cardiology Deck (297)
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1

most common cause of death in US

CAD

2

CAD risk factors (8)

1. diabetes mellitus
2. hypertension
3. tobacco use
4. hyperlipidemia
5. peripheral arterial disease (PAD)
6. obesity
7. inactivity
8. family history

3

what is considered "significant" in the family history of CAD?

- females > 65 years of age
- males > 55 years of age

4

chest pain that changes with RESPIRATION

pleuritic pain

5

causes of PLEURITIC chest pain

1. PE
2. pneumonia
3. pleuritis
4. pericarditis
5. pneumothorax

6

cause of chest pain that is tender to palpation

costochondritis

7

causes of POSITIONAL chest pain

pericarditis

8

clues that chest pain is ISCHEMIC in nature

1. dull pain
2. last 15-30 minutes
3. exertional
4. substernal location
5. radiates to jaw or left arm

9

S3 gallop indicates

DILATED left ventricle

10

mechanism of S3 gallop

rapid ventricular filling during diastole

11

mechanism of S4 gallop

atrial systole into a stiff or noncompliant left ventricle

12

S4 gallop indicates

left ventricular HYPERTROPHY

13

best INITIAL step in presentation of chest pain

ASPIRIN

14

which test is best to detect REINFARCTION a few days after initial infarction?

CK-MB

15

which cardiac enzyme rises first?

myoglobin

16

if initial EKG and/or enzymes do NOT establish diagnosis of CAD, next step

stress test

17

when should you order a dipyridamole or adenosine thallium stress test, or dobutamine echocardiogram?

patient can't exercise to target HR of > 85% of maximum

18

situations where patient won't be able to do an exercise stress test

1. COPD
2. amputation
3. deconditioning
4. weakness/previous stroke
5. LE ulcer
6. dementia
7. obesity

19

when should you answer exercise thallium testing, or stress echocardiography?

EKG is unreadable for ischemia

20

situations where EKG may be unreadable for ischemia

1. LBBB
2. digoxin use
3. pacemaker
4. LVH
5. baseline ST segment abnormality

21

next diagnostic test to evaluate an abnormal stress test

angiography

22

mechanism of thallium (nuclear isotope)

decreased uptake = damage

23

- causes acute chest pain
- can occur with exertion or at rest
- ST segment elevation, depression, or normal EKG
- NOT based on enzyme levels, angiography, or stress test results
- BASED ON h/o chest pain with features suggestive of ischemic disease

definition of acute coronary syndrome (ACS)

24

best initial therapy for all cases of ACS

ASPIRIN

25

benefit of using aspirin in ACS

instant effect of inhibiting platelets

26

can be given in ACS, but do NOT lower mortality

nitrates and morphine

27

added to aspirin for patients with ACUTE MI

clopidogrel or ticagrelor

28

only given when angioplasty is done

prasugrel

29

MOA of clopidoGREL, ticaGRELor, and prasuGREL

inhibit ADP activation of platelets

30

what LOWER MORTALITY in STEMI and are TIME DEPENDENT?

thrombolytics and PCI