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26 Cards in this Set
- Front
- Back
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three features to call angina, unstable
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occurring at rest greater than 20 mins
being severe described as frank pain and of new onsent occurring with a crescendo pattern |
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TIMI risk factors (memorize) 7
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age greater than or equal 65
3 or greater risk factors for CAD documented CAD at cath ST deviation > 0.5 2 or greater of angina in last 24 hours aspirin use within the prior elevated cardiac markers |
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Physical examination high risk clinical features
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pulmonary edema
new/worsening MR S3 or new/worsening rales hypotension, bradycardia or tachycardia age >75 |
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completely normal ekg with pt with chest pain does not exclude...
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ACS, some eventually foudn to have NSTEMi
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aspirin inhibits
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COX-I blocking syn of thomboxane A
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clopidogrel blocks
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p2y12 ADP receptors on platelets
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pt suspected of ischemia is pain free and cardiac markers/ecg are negative what do you do, risk stratification
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early stress test to provoke ischemia, can refer to outpatient test in 72 hours, but should put on appropiate pharms, if abnormal ecg perfusiong/echo
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chest pain...give me the medical therapy
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nitrates, beta blockers, morphine, ccbs
O2 questionable benefit |
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early invasive strategy is equally beneficial to high risk women with elevated biomarkers?
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yes!
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percutaneous coronary intervention is performed on leisons with _____ stenosis
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70% or greater
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CABG is preferred revascularization method in pts with...
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significant left main disease (>50%)
trhee or two vessel disease who have significant proximal LAD stenosis and either txed diabetes or LV dysfx |
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when should statins be given to post-UA NSTEMI pts
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always, levels should be <70
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should ACS pts be given ACEi?
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yes, in the absence of hypotension or other contras
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For STEMI, gimme patient centered goals for reperfusion therapy
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first medical contact-to-balloon time <90 minutes
first medical contact to needle time <30 |
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all fibrinolytic agents share common propertry of activating...
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plasminogen
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free wall rupture timing
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peak5th day, first 48 with reperfusion
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free wall rupture murmur?
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no
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free wall rupture symptoms
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sudden death, chest pain, syncope, cardiogenic shock
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acute MI VSD timing
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first, and third to fifth days
first 24 with reperfusion |
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acute MI in VSD murmur?
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holsystolic loud
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papillary muscle rupture timing?
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2-7 days
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papillary muscle rupture symptoms?
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acute dyspnea, pulmonary edema
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RV infarction timing?
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first 24 hours
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RV infarction symptoms?
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dyspnea, hypotension, elevated jugular venous pressure
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three phases of cardiac arrest
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electrial 4mins (defib good prognosis)
circulatory 4-10 mins metabolic |
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ICD therapy is indicated when
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structural heart disease and spontaneous sustained Vtach
in pts with LVEF less than 35% due to prior MI who are least 40 days post MI and are i n CLass 2 or 3 HF |
