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Flashcards in step 3 5 Deck (22):
1

what is EPS

dystonia, akathisia, or parkinsonism

2

by far leading cause of death in our country

coronary artery disease

3

biggest RF for CAD

diabetes

4

most common cause of chest pain that is not cardiac in etiology

GERD

5

best test for evaluating EF

nuclear ventriculogram

6

mortality affect of ACEis/ARBs in ACS

only with LV dysfunction or systolic dysfunction

7

ACS interventions that lower mortality

aspirin, thrombolytics, primary angioplasty, metoprolol, statins, clopidogrel, ACE/ARBs ( if EF low)

8

NSTEMI vs. STEMI

No lytics in NSTEMI, and anticoagulation is used

9

cardioselective betablockers

metoprolol, atenolol

10

how to determine if someone needs a CABG

significant changes on stress testing → coronary angiography → determine if candidate for CABG

11

better graft for CABG

internal mammary artery (10 yrs) vs saphenous vein (5 yrs)

12

CABG indications

- 3 coronary vessels with 70 percent stenosis
- left main coronary artery stenosis 50-70 percent
- 2 vessels in a diabetic
- 2 or 3 vessels with low EF

13

CAD management

ASA
Metoprolol
Statin with LDL goal <70

14

ACSVD cut-off for statin

7.5%

15

why do we use statins?

proven mortality benefit

16

PCSK9 inhibitors

evolocumab, alirocumab

17

use of PCSK9 inhibitors

severe hyperlipidemia (familial hypercolesterolemia) not responsive to statins

18

new cardiac drugs

Ivabradine
Sacubitril/valsartan
both shown to have mortality benefit.

19

HFpEF management

beta blockers and diuretics (verify)

20

meds with mortality benefit in CHF

ACE/ARB, betablocker, spironolactone

21

severe HFrEF management

IF EF <35% → ICD
IF EF <35% + QRS > 120 → biventricular pacemaker (IE cardiac resynchronization therapy)
consider life vest
→ think about discontinuing betablocker (may be exacerbating fluid overload/pulmonary edema).

22

absolute contraindication to beta blocker

symptomatic bradycardia