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Flashcards in Cardio treatments Deck (46)
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1

what are the 3 steps in treatment of unstable angina + NSTEMI?

1) MONA C
2) could add fondaparinux (similar to LMWH)
3) Revascularisation
- PCI
- Thrombolysis if too late
- CABG (if >3 vessels affected)

2

what are the steps in treatment of STEMI?

1) diaMorphine + anti-emetic (metoclopramide)
2) oxygen
3) GTN
4) Aspirin (300mg chewed)
5) Clopidogrel/tricagrelor 300mg
6) PCI (angioplasty) within 90 mins
- Thrombolysis if PCI unavailable (streptokinase + aspirin)
7) emergency angioplasty if this fails

3

what are the contradindications for emergency angioplasty?

trauma
haemorrhage
ulcers
recent surgery
severe hypertension

4

what is PCI?

percutaneous coronary intervention
AKA angioplasty with stent

5

what are the 5 stages of treatment for stable angina?

1) GTN
2) secondary prevention: aspirin, ACE, statins
3) beta blockers/CCBs(amlodipine)
4) isosorbide mononitrate/ivabradine
5) CABG/PCI

6

how is heart failure investigated?

1) transthoracic ECHO
- systolic = low ejection fraction
- diastolic = LVH
2) ECG
3) CXR
4) FBC

7

what is the treatment for acute heart failure?

1) sit up
2) oxygen
3) IV furosemide
4) IV diamorphine

8

what is the treatment for chronic heart failure?

1) lifestyle advice
2) furosemide + bendroflumethiazide at start
3) ACE + Beta blockers
4) Spironolactone
5) Digoxin, ivabradine
6) other vasodilators - nitrates, hydralazine
7) ICD/CRT (if LBBB)
8) CABG (check eligibility via catheterisation)
9) cardiac transplant

9

what are the stages of treatment in SVT?

1) vagal manoeuvres: Valsalva movement/carotid massage (massage only in young and fit)
2) IV adenosine
3) IV verapamil

10

what are the steps in treatment of atrial fibrillation?

1) digoxin + CCB/Beta blocker
2) AAD class I (disopyramide) and III (amiodarone)
3) DC cardioversion if able to cardiovert (paroxysmal/persistent)
4) If permanent then AV node ablation or pacing in older patients
5) anticoagulate for stroke risk (esp in prosthetic valves)

11

what are the steps in treatment of atrial flutter?

1) amiodarone
2) DC cardioversion
3) RF ablation
4) anticoagulation

12

what are the steps in treatment of ventricular tachycardia?

1) Unstable = DC cardioversion
2) pulseless = defibrillation
3) stable = class 1 (disopyramide) + class III (amiodarone)
4) calcium chloride if hyperkalaemia
5) ICD (if life threatening)

13

what is the treatment for ventricular fibrillation?

1) defibrillation
2) IV magnesium chloride
3) ICD (first line long term)

14

what is ICD?

implantable cardiac defibrillator

15

what is torsades de pointes?

polymorphic ventricular tachycardia

16

what is the treatment fot torsades de pointes?

1) IV magnesium chloride
2) isoprenaline
3) pacemaker

17

what is the treatment for sinus bradycardia?

1) IV atropine
2) pacing (permanent if sick sinus syndrome)

18

how is 1st degree heart block treated?

stop block medications

19

how is2nd degree heart block treated?

mobitz type 1 = stop block medications
Mobitz type 2 = pacemaker + atropine

20

how is 3rd degree heart block treated?

pacemaker + atropine

21

what is the treatment for bundle branch block?

1) IV atropine
2) Pacemaker

22

what is the treatment for mitral regurgitation?

1) diuretics and ACE
2) surgical
- repair = prolapse
- replacement = degenerative
3) percutaneous
- clips in infancy

23

what is the treatment for mitral stenosis?

1) diuretics, beta blockers, digoxin (treat AF)
2) mitral valve replacement
3) balloon valvotomy

24

what is the treatment for aortic regurgitation?

1) diuretics and ACE
2) aortic valve replacement

25

what is the treatment for aortic stenosis?

1) aortic valve replacement
2) balloon valvotomy
3) TAVI

26

what is the treatment for empirical native valve infective endocarditis?

amoxicillin + gentamicin

27

what is the treatment for empirical prosthetic valve infective endocarditis?

vancomycin + gentamicin

28

what is the treatment for staph aureus infective endocarditis?

flucoxacillin

29

what is the treatment for MRSA endocarditis?

vancomycin + gentamicin + rifampicin PO

30

what is the treatment for strep viridans endocarditis?

penicillin + gentamicin