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35 Cards in this Set
- Front
- Back
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What part of the heart is MC for MI?
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Left Ventricle
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What characterizes stable angina pectoris?
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transient ischemia with exertion
-pain that subsides at rest decreased arterial pulses, normal enzymes |
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What is the gold standard for determining plaque formation?
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Coronary angiography
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What are the 5 indications for arteriography?
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1-chest pain that is unresponsive to max dose of meds
2- need to ID lumens 3- survivor of cardiac arrest 4- ID plaques with abnormal stress test 5- eval high risk pts based on sx and stress test |
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What are the indications for CABG?
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Left main vessel stenosis
3 or more diffuse vessles DM |
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What is more common: STEMI or NSTEMI?
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NSTEMI
by a lot |
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What characterizes unstable angina?
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sx at rest, lasting more than 10 min, sever and associated with SOB
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What are the 4 causes of NSTEMI and which one is the most common?
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1- plaque rupture (MC)
2- dynamic obstruction (spasm) 3- progressive obstruction d/t atherosclerosis 4- increased demand or decreased supply |
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What does an apical systolic murmur indicate in a pt with NSTEMI?
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Papillary muscle dysfunction
-bad sign--lots of damage |
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What distingiushes unstable angina from NSTEMI?
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Cardiac biomarkers
-present with NSTEMI -Troponins better than CK |
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What are the AHA/ACC dx guidelines for MI?
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Typical chest pain
age and gender prior hx CAD abnormal EKG increased biomarkers |
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What are the TIMI risk factors?
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RF score, ekg, biomarkers
-age >65, >3 CAD RF, prior stenosis >50%, ST deviation, >2 angina events in 24 h, ASA last 7 days, elevated cardiac markers |
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When is early invasive procedures recomended?
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recurrent angina with tx
elevated troponin T/I new ST depression + stress test EF <40% decreased BP sustained V Tac PCI <6 months or prior CABG |
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WIth fatal MIs, when people die before reaching the hospital, what is the cause?
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Arrythmias
-V tac |
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WHat type of MI is seen with partial occlusion? Total oclusion?
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Partial--NSTEMI/NQ MI
Total--STEMI/Q MI |
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Who is more likely to have a silent MI?
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DM
elderly |
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What are the 3 phase of a MI?
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acute (7days)--most dangerous
healing (7-28d) healed (>28 d) |
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T/F
an echocardiogram must be done if a MI is suspected? |
True
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TX for MI?
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MONA + BB + Reprofusion
Morphine Oxygen (if sat <92) Nitroglycerine Aspirin Oral Beta blockers reprofusion (TPA, PCI, CABG) |
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How long after on-set of sx should reprofusion therapy be initiated?
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TPA in 30 min
PCI in 90 |
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What are the 5 main complications post MI?
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LV dysfunction
Cardiogenic shock arrhythmias thromboembolism LV aneurysm |
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Post MI, what occurs with the RAA system that makes LV dysfunction worse?
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RAA system activated (need ACE I/ ARB) which increases pre-load and stretched the LV further
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What EF point is usually fatal?
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Less than 25%
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What % loss of tissue usually leads to cardiogenic shock?
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40%
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When does cardiogenic shock usually occur?
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24-48 h post MI
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What is the tx for cardiogenic shock?
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intra-aortic balloon pump
NO thrombolytics, PCI/ CABG |
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What is the tx of choice for sustained arrythmias?
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Amiodarone
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When do you consider an implantable defibrilator?
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if V fib is occuring 48 hours + after MI
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What is the MC supraventricular arrythmia, and tx of choice?
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sinus tachy
Beta blockers if >2-3 h, >120 bpm- electrocardio conversion |
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What is the tx for sinus bradycardia?
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fluid if decreased volume
atropine if <40 bpm, pacemaker |
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Where in the heart do thrombi usually form?
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LV/LA apendage
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Where is the MC sites for a cardiac thromi to travel to ?
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Cerebral
Pulm |
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What is a true aneurysm in the heart?
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Scar tissue- very rare to rupture
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What is the MC site for a cardiac aneurysm?
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LV apex
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What is a cardiac psuedo-aneurysm?
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local LV rupture
contained by the pericardium with time, rupture or cardiac tamponade |
