Flashcards in Cardiology Deck (257)
State the arterial supply to the lateral leads
Name the leads that correlate to the lateral area of the heart
State the arterial supply to the inferior leads
right coronary artery
State the arterial supply to the anteroseptal leads
Name the leads that correlate to the inferior area of the heart
Name the leads that correlate to the anteroseptal area of the heart
What is the initial management of ACS?
o2 if <94%
12 lead ECG
sublingual GTN spray
diamorphine IV + metaclopramide IV
?ticagrelor, clopidogrel or prasugrel
Glycoprotein IIb/IIIa inhibitors
What investigations would you do in ACS?
Bloods: FBC U+E LFTs glucose lipids troponin I
Imaging: portable CXR
What are the indications for thrombolysis or PCI in STEMI?
+ any of
ST elevation >1mm in 2 limb leads
ST elevation >2mm in 2 chest leads
new onset LBBB
What are the absolute contraindications for thrombolysis?
recent trauma or surgery
GI bleed <1m
What are the relative contraindications for thrombolysis?
advanced liver disease
State the complications of thrombolysis
systemic embolisation of thrombus
What drug is used for thrombolysis in STEMI?
What are the complications of a STEMI?
S udden death
R upture papillary muscles
D ressler's syndrome
What drugs should a patient be prescribed post MI?
Clopidogrel/prasugrel (STEMI)/ticegralor (NSTEMI)
In terms of work and driving, what should a patient be advised post MI?
off work for 1 month
need to inform DVLA - no driving for 1 month
How can you distinguish between NSTEMI and unstable angina?
troponin I 12hrs after onset
+ve for NSTEMI
-ve for unstable angina
How is an NSTEMI treated?
LMWH - fondaparinux
Beta blocker or calcium chanel blocker
When should PCI be considered in a patient with NSTEMI?
rise in troponin I
recurrent angina/ischaemic ECG changes despite therapy
heart failure develops
poor LV function
Name some narrow complex tachycardias
junctional tachy - - AVNRT/AVRT
multifocal atrial tachycardia
How do you manage a regular narrow complex tachycardia?
adenosine 6mg IV bolus
How does adenosine work?
inhibition SAN and AVN
Leads to AV block
What are the vagal manouevres?
carotid sinus massage
Valsalva - hold breath and bear down
If adenosine fails, and the patient is haemodynamically compromised in regular SVT, what next?
Amiodarone 300mg IV
If adenosine fails, and the patient is haemodynamically stable in regular SVT, what next?
What could cause a broad complex tachycardia?
VT - most common! until proven otherwise
SVT with BBB
SVT with aberrancy
If the patient is unstable, how should a VT be managed?
If the patient is stable, how should a VT be managed?
amiodarone 300mg IV
If SVT, give adenosine
What is the most common organism to cause endocarditis?
Staph aureus in IVDU
Staphylococcus epidermidis in valve surgery <2m ago