Flashcards in Myocardial infarction III Deck (32)
do arrhythmias occur during STEMIs, NSTEMIs, or both?
what is the most common type of arrhythmia seen with MI?
what is done for PVCs?
when is accelerated idioventricular rhythm observed?
shortly after successful reperfusion
accelerated idioventricular rhythm is a result of what type of conduction abnormality?
enhanced automaticity of purkinje fibers
VT induced by ischemia has what morphology?
VT induced by scarring has what morphology?
what is the significance of having late VT/VF (after 48 hours) following MI?
increased risk of sudden cardiac death
what are the high risk factors for sudden cardiac death?
EF less than 35% (strongest factor)
what is the strongest risk factor for sudden cardiac death?
EF less than 35% when leaving the hospital
inferior MIs typically result from a block at what level?
what are three causes of inferior MIs due to AV nodal block?
high parasympathetic tone
local accumulation of K, adenosine
AV node ischemia
what is the best management option for acute MI phase of heart failure?
vasodilators (NTG unless hypotensive)
what are the three management options for post acute phase of heart failure?
aldosterone antagonists (spironolactone, epleronone)
what is the treatment for cardioembolism?
anticoagulation with warfarin
what type of pain characterizes pericarditis?
pleuritic, can radiate to trapezius
what is the treatment for pericarditis?
aspirin (650 mg for 4-6 hours)
what treatments should be avoided in pericarditis?
the syndrome for late pericarditis goes by what name?
what is dressler's syndrome?
(late) pericarditis plus systemic symptoms (malaise, arthralgias, fever, pleural / pericardial effusions, high sedimentation rate, CRP)
what is the mechanism type for dressler's syndrome?
what is the treatment for dressler's syndrome?
how does auscultation of a VSD differ from mitral regurg?
in VSD the murmur is found at the LLSB as opposed to the apex and typically louder
acute mitral regurg is found primarily in the setting of inferior MI involving which papillary muscle?
what is the best diagnostic test for mitral regurg?
echo or TEE
how can VSD be differentiated from papillary muscle rupture?
VSD - loud holosystolic murmr as LSB
MR - may be faint, more commonly at apex
VSD - can lie flat
MR - cannot lie flat
what are the risk factors for free wall rupture?
history of HTN
echo will show what features for free wall rupture?
pericardial effusion, tamponade
all three layers are present