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35 Cards in this Set
- Front
- Back
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what are the 10 risk factors for an MI?
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hypercholesterolemia
hypertriglyceridemia low HDL HTN smoking hyperglycemia and diabetes mellitus obesity sedentary lifestyle type A personality genetic factors |
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what is the time frame for chest pain caused by angina? why is there a minimum? what happens after that time frame if the pain continues?
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5-30 minutes. There is a minimum because if the chest pain goes away w/n 5 minutes its not angina. After 30 minutes the pt is infarcting
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how can you decipher whether or not someone is lying about having an MI on PE?
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diaphoresis. Diaphoresis cannot be controlled
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what would you see on PE of a pt who is having an MI?
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pallor, mild tachycardia, low grade fever
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what does an elevated jugular venous pulse indicate?
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right ventricular involvement
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what does an elevated jugular venous pulse + hypotension or rales indicate?
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congestive failure
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S3 is heard during what heart phase? why?
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occurs during the first 1/3 of diastole because there is too much fluid to fill the ventricle and it passively flows into the ventricle
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S4 is heard during what heart phase? why?
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last part of diastole d/t atrial contraction occurring right before the ventricle contracts
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which heart sound is specific for a stiffened ventricle? which one is specifically for volume overload?
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stiff- S4
overload- S3 |
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why do you hear mitral regurg murmur in ischemia?
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due to the siffening of papillary muscles which will lead to mitral valve regurgitation.
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what are the four heart sounds heard in a pt w/ MI?
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S4 common at apex, S3 (indicating severe damage w/ impending HF), mitral regurg mumur, pericardial friction rub
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what are the two specific and sensitive markers of myonecrosis in a pt w/ MI?
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troponin I and T
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what are the four tests that you can do in your laboratory evaluation of an MI pt?
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Troponin, CPK, AST, LDh
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what is the first finding on EKG of an MI? what findings are found hours later?
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1st- ST segment elevation (injury)
next: Q wave (3-6 hrs later) next: inverted T wave. |
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what is a stemi? what does it usually define/ what does it have more of? Mortality?
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ST-elevation myocardial infarction.
Usually defines transmural infarct, usually more myocardial necrosis and acute mortality is higher. |
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what is a NON-stemi? how do you diagnose it? what level of damage and mortality is associated? what else is it usually associated with?
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Non ST elevation myocardial infarction. Diagnosed w/ ST segment depression (ischemia) and elevated enzymes. Usually less total damage and acute mortality is lower than STEMI. BUT subsequent mortality is higher than STEMI. It is usually associated w/ more extensive coronary plaque.
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what is a common sign of reperfusion after thrombolysis?
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accelerated idioventricular rhythm
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what type of arrhythmia occurs in 10-15%, usually transient and is a marker of LV dysfunction?
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a. fib/ flutter
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what type of AV block is common w/ inferior MI?
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first degree
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T/F
Wenkebach is more ominous than type 2 AV block in MI |
FALSE
type 2 is more ominous |
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what does a second degree AV block type 1 indicate? what type of MI is it more common with?
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indicates more advanced AV node disease. Is more common w/ inferior MI.
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what is the difference bwteen second degree AV block type 1 and type 2 as far as tx goes in a MI pt?
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type 2 requires pacing unless completely stable and asymptomatic
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what does left ventricular failure correlate with? what is it associated with? What is it the highest risk marker for?
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Correlates w/ degree of damage.
associated w/ signs of pulmonary congestion and low CO Highest risk marker for subsequent cardiac mortality |
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what is a late complication of anterior MI? what can it cause?
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LV aneurysm; can cause refractory HF, arrhythmia, or embolus
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why doesn't the RV usually infarct? what must you think if you find a RV infarction? why?
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because its thinner and it doesn't burn as much oxygen. Must think right coronary artery because the RCA supplies the inferior wall of the left ventricle.
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low BP (in site of therapy) + inferior wall MI.... what has infarcted?
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Right infarction due to RCA
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Thromboembolism is most common with what two types of MIs? (location/ size)
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anterior or large
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in what populations are cardiac ruptures more common?
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elderly, females, and first MI
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sudden loss of pulse + electromechanical dissociation in female w/ MI.
what do you think? |
cardiac rupture
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which infarcts are txed more aggressively STEMI, NON-STEMI? why?
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STEMI because you can save more tissue by opening up the vessel wall acutely.
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what type of ST segment change can you use IV thrombolysis?
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ST elevation in 2 leads NOT ST depression
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what is the time window for IV thrombolysis? when is it CI?
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less than 12 hours ideally less than 6 from onset of pain.
CI: active bleeding, recent CVA, surgery, bleeding disorder, trauma |
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what is the adjunctive therapy for MI?
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heparinization
IV nitro aspirin IV b-blocker oxygen ace inhibitor 2b3a inhibitor |
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what is difference between STEMI and NON STEMI in tx?
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interventional therapy
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how do you tx acute pericarditis?
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nonsteroidals
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