Cardiology workbook Flashcards
What is the ECG diagnosis
Inferior STEMI, RCA
Immediate management of STEMI patient before cardiologist arrives and after
Before: MONA IV
Morphine, O2 if sats <94%, nitrates, Aspirin 300mg loading and anti nausea (ondansetron), secure IV access
A-E assessment
After: transfer to cath lab
What long term medications should be prescribed following MI, prior to hospital discharge, to improve outcomes
ATABS
Aspirin 75mg OD for life, Ticagrelor (or prasugrel or clopidogrel), ACEi/ARB (LV remodelling), B blocker, Statin
Features of CXR suggestive of heart failure
Cardiomegaly, alveolar oedema, perihilar shadowing
Why do patients with heart failure develop ankle oedema
Heart cannot pump effectively, blood backs up into veins, increased pressure pushes fluid out due to higher hydrostatic pressure,causes swelling
Treatment for acute presentation of heart failure vs chronic
Acute: loop diuretics, O2 or CPAP, nitrates
Long term: ACEi, B blocker, (aldosterone antagonist?)
What does this ECG show
A fib, irregularly irregular
Acute treatment for A fib
Cardio version (electrical or flecainide) + amiodarone
Example of indication for electrical DC cardioversion
Haemodynamic instability
3 commonest causes of A fib and investigation for that
Heart failure (e.g. post MI): ECG
Valvular disease: echo
Acute infection: FBC,CRP,blood cultures
What is WPW syndrome
Re entry loops
What drugs cannot be used in WPW
No rate control e.g. beta blockers, no adenosine, no CCB or digoxin
What drugs are used in long term treatment of permanent AF
Anticoagulation e.g warfarin/DOAC, rate control e.g. B blockers/CCB/digoxin, rhythm control e.g. cardioversion
What scoring systems are used to decide if a patient with AF should be taking long term anticoagulation
CHADSVASC and HAS-BLED
Clinical features of aortic stenosis
Slow rising pulse, narrow pulse pressure, heaving apex beat, ejection systolic 2nd ICS RHS heart murmur radiating to neck/carotids loudest on expiration, reduced or absent S2