Week 2 Flashcards by Ivy Jones

symptoms of angina (5)

chest pain
referred pain
dyspnoea
sweating
fatigue
syncope

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mech of dyspnoea in cardiac issues (MI, HF, ischaemia) 4 steps

1.reduced cardiac ouput
2. increased pulmonary pressure
3. interstitial oedema and pulmonary congestion
4. gas exchange impairment

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what are the nerves involved in referred pain in MI

cardiac visceral spinal afferents

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reason for referred pain

the cardiac visceral spinal afferents converge with sensory nerves from chest and upper limbs at the same spinal nerves hence referred pain

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what are the key spinal nerves from which referred pain is derived from

c3-T5

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aortic dissection pain 2 characteristics

tearing pain
radiates to back and shoulder

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pericarditis 2 characteristics

sharp
worse upon deep breathing

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pulmonary embolism 3 characteristics

pleuritic pain: sharp, stabbing
worse uppon inspiration
radiation to back and shoulder

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pneumothorax pain 2 charateristics

pleuritic pain: sharp, stabbing
worse upon inspiration

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GORD pain 2 characteristics

burning central pain
worse after eating and lying down

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ECG findings for unstable angina and NSTEMI (2)

ST depression, T wave inversion

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what other conditions cause high troponin 7

pericarditis
myocarditis
physical activity
stroke
sepsis
trauma
pulmonary embolism

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what are the two key troponins

I and T

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TIMI score (7 criteria)

risk assessment for unstable angina and NSTEMI

age>65
Aspirin
Prior stenosis
ST depression
Cardiac markers
>3risk factors
Angina

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ED presentation for STEMI process 5

insert cannula
aspirin
analgesic
ECG every 10min
establish reperfusion method

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discharge after ACS 6

dual antiplatelet (aspirin+ticagrelor)
ACE inhibitor
Beta blocker
High intensity statin
Cardiac rehab
Other risk factor management

type 1 MI

due to plaque rupture or erosion

type 2 MI

due to oxygen supply demand mismatch

type 3 mi

sudden cardiac death without elevated biomarkers

type 4 MI

death during PCI

type 5 MI

death during cardiac surgery

causes of type 2 (think groups then examples of each)

Oxygen delivery: RF, PE, pneumothorax
Heart rate: tacchycardia
BP: severe hypertension, hypotension
Coronary: vasospasm, endothelial dysfunction, dissection

causes of vasospasm 3

smoking
drugs
endothelial dysfunction

symptoms of coronary artery spasm

same as mi: dyspnoea, tachycardia, syncope, referred pain, chest pain

benefits of fibre in reducing coronary artery risk 2

1. absorb cholesterol allowing more excretion than absorption 2. reduce rate of sugar absorption important in diabetes management which is major risk factor of CAD

benefits of plant sterols and stanols

similar structure to cholesterol hence compete for absorption, reducing cholesterol absorption

DASH diet

dietary approaches to stopping hypertension includes low salts

signs of PAD 2 generic

asymptomatic intermittent claudication

severe signs of PAD progression

palor pulselessness cold parasthesia paralysis pain beurger's sign gangrene ulcerations charcots foot

symptoms of stroke 6

hemiparesis confusion aka dysarthia dysphasia syncope unilateral vision loss hemi-negligence

where does cerebrovascular atherosclerosis most commonly occur

in carotids, specifically the bifurcation between common to internals

PAD management

pharmacological: dual antiplatelet, statins, ACE (to control BP) Bypass Stenting

CBV management

Gold standard: Carotid artery endoarterectomy if stenosis >50% carotid stenting pharmacological: statins, dual antiplatelet, ACE

ethics of tolerance

Acceptance of other beliefs even if they do not align with one's as long as they do not cause harm

AFIB signs on ECg

irregular irregular rate and rhythm absence of p waves