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19 Cards in this Set
- Front
- Back
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What are the risk factors for ACS? |
Non modifiable risk factors for atherosclerosis such as increasing age, male, FH of premature coronary heart disease, premature menopause Modifiable RF for atherosclerosis: smoking, DM, hypertension, dyslipidaemia, obesity, inactivity |
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When dose a troponin rise occur in cardiac ishaemia? |
Troponin I and T become detectable 3-6 hours after infaraction, peak and 12-24 hours and remain raised for up to 14 days |
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At what times after onset of cardiac chest pains are troponin levels taken? |
6 and 12 hours |
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Which scoring system is recommended by NICE to assess risk of future advers cardiovascular event? |
GRACE score http://www.gracescore.org/website/webversion.aspx |
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What is the immediate treatment of a patients with ischemic ECG changes or elevation of cardiac troponin? |
Aspirin 300mg Ticagrelor 180 mg |
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Which antithrombin managment is recommended in the inital treatment of NSTE-ACS |
Fondaparinux (unless angiography planned within 24 hours or risk of bleeding) |
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What medications should a patient be started on following a NSTE-ACS (to be continued long term)? |
Clopidogrel + aspirin duel therapy Nitrates B-blockers or calcium antagonist ACE inhibitors Statins Diabetes management where appropriate |
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What may be found on abdominal examination in a patient with right heart failure? |
Hepatomegaly |
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What diagnosis must be ruled out in a patient with a fever and a new or changing murmur? |
Infective endocarditis |
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Name the murmur heard in: Aortic regurgitation Aortic stenosis Mitral regurgitation |
- Early diastolic murmur - ejection systolic - Pan systolic murmur |
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What is the mechanism of action of adenosine, what dose it is usually started at and when is it contraindicated? |
It is used in certain SVTs and slows conduction at the AV node 6mg Asthma, 2nd or 3rd degree HB, decompensated heart failure |
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What metabolic abnormality can lead to SVT? |
Hypokalaemia |
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In Western countries what is the most common pathogen in infective endocarditis? |
steptococcus virdidans |
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A 28 year old male is admitted with sharp chest pain that is eased by lying down and an ECG showed ST elevation in all leads, what is the most likely diagnosis? |
Pericarditis |
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Describe a pericaridal rub |
A clinical sign associated with pericarditis and is an extra heart sound heard on auscultation, typically with three components (1 systolic and 2 diastolic). It resembles the sound of squeaky leather and often is described as grating, scratching or rasping. It is usually heard best between the apex and the sternum |
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What are some ECG findings of left ventriclar hypertropy? |
tall R waves in V6 and T wave inversion in I aVL V5 and V6 |
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What is the most common congenital cardiac malformation? |
ventral-septal defect |
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ST elevation is seen in III and aVF, which coronary artery is likely affected ? |
Right coronary artery |
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What are some features of tetralogy of Fallot? |
Overriding aorta Ventricular septal defect Right ventricular hypertrophy Pulmonary stenosis |
