Ischaemic Heart Disease Flashcards Preview

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Flashcards in Ischaemic Heart Disease Deck (49)
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1

How soon after an MI can patients return to sexual activity?

4 weeks

2

What are the driving rules after an MI?

Car drivers can return to driving after 4 weeks and do not have to inform the DVLA. HGV/bus drivers can return to driving after 6 weeks and must inform the DVLA.

3

As a result of VSD or sub-mitral valve papillary muscle rupture, what murmur may develop after an MI? How does it sound?

Mitral regurgitation / pansystolic murmur

4

What is Dressler's syndrome?

Autoimmune pericarditis occurring 2-10 weeks after an MI

5

Describe what is involved in the MONA acronym for the initial treatment of STEMI?

Morphine (+ anti-emetic), oxygen (only if hypoxic), nitrates, anti-platelets (aspirin + ticagrelor)

6

What are the interventional management options for STEMI?

Primary PCI or thrombolysis

7

What anti-emetic should be given alongside IV morphine when treating NSTEMI?

IV metoclopramide

8

How can GTN be given in a STEMI?

Sublingual, oral or IV

9

Which patients should be given nitrates when treating a STEMI?

If systolic BP > 90mmHg

10

What dose of aspirin, clopidogrel and ticagrelor should be given in the acute treatment of a STEMI?

300mg aspirin + clopidogrel, 180mg ticagrelor

11

What are some potential interventions for the primary prevention of ACS?

Smoking cessation, cholesterol reduction, tight control of hypertension/diabetes

12

In addition to chest pain and dyspnoea, what are some other potential symptoms of ACS?

Sweating, nausea/vomiting

13

Which acute coronary syndrome(s) will cause chest pain that is relieved by GTN spray?

Unstable angina

14

Which acute coronary syndrome(s) may cause an abnormal ECG?

NSTEMI and STEMI (NSTEMI may or may not be abnormal, STEMI will always be abnormal)

15

Which acute coronary syndrome(s) will cause a rise in troponins?

NSTEMI and STEMI

16

Which ECG leads, and which artery, correspond to the anteroseptal territory of the heart?

V1-V4, left anterior descending artery

17

Which ECG leads, and which artery, correspond to the lateral territory of the heart?

I, aVL, V5 & V6, left circumflex artery

18

Which ECG leads, and which artery, correspond to the inferior territory of the heart?

II, III & aVF, right coronary artery

19

What ECG change can be seen in a posterior STEMI?

ST depression in the anterior leads V1-V4

20

When a patient presents with a possible ACS, what 3 basic investigations should be done ASAP?

ECG, CXR, bloods (FBC, U&E, lipid profile, troponins)

21

What is the gold standard investigation for ACS?

Coronary angiography

22

For best results, when should a measurement of troponin be taken?

12 hours after the onset of pain

23

What medical management is required for cases of NSTEMI and unstable angina?

Dual anti-platelet therapy and an anti-coagulant

24

What can be used for pain control in cases of NSTEMI/unstable angina? What should be co-prescribed?

IV opiates and nitrates / co-prescribe an anti-emetic

25

In which group of patients should anticoagulation not be given, when presenting with NSTEMI/unstable angina?

If cardiac catheterisation is scheduled for the same day

26

What interventional management options may be offered to patients with NSTEMI/unstable angina?

PCI or CABG

27

Describe the typical clinical feature of angina?

Chest pain which is worse on exertion and relieved by rest and the use of GTN spray

28

What are some non-modifiable risk factors for the development of ischaemic heart disease?

Increasing age, male gender, family history

29

What are the four main modifiable risk factors for the development of ischaemic heart disease?

Smoking, diabetes, high cholesterol, hypertension

30

What are some potentially exacerbating factors for chest pain caused by ischaemic heart disease?

Exertion, stress, large meals