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This document summarizes key information about diagnosing and treating cardiac issues:
- An EKG is more sensitive than cardiac enzymes for detecting chest pain, while myoglobin can detect reinfarction. ST elevation or left bundle branch block on EKG indicates a STEMI.
- Troponin I is the most sensitive cardiac enzyme, rising in 3-5 hours and normalizing in 7-10 days. CKMB rises in 4-8 hours and normalizes in 72 hours. Myoglobin is most sensitive for reinfarction.
- Treatment for cardiac issues includes medications like aspirin, beta blockers, ACE inhibitors, and statins, as well as interventions like stents or bypass
Originalbeschreibung:
Title is self explanatory. For 3rd year medical students preparing for the Internal Medicine shelf
Originaltitel
High Yield Cardio Topics for Internal Medicine Shelf
This document summarizes key information about diagnosing and treating cardiac issues:
- An EKG is more sensitive than cardiac enzymes for detecting chest pain, while myoglobin can detect reinfarction. ST elevation or left bundle branch block on EKG indicates a STEMI.
- Troponin I is the most sensitive cardiac enzyme, rising in 3-5 hours and normalizing in 7-10 days. CKMB rises in 4-8 hours and normalizes in 72 hours. Myoglobin is most sensitive for reinfarction.
- Treatment for cardiac issues includes medications like aspirin, beta blockers, ACE inhibitors, and statins, as well as interventions like stents or bypass
This document summarizes key information about diagnosing and treating cardiac issues:
- An EKG is more sensitive than cardiac enzymes for detecting chest pain, while myoglobin can detect reinfarction. ST elevation or left bundle branch block on EKG indicates a STEMI.
- Troponin I is the most sensitive cardiac enzyme, rising in 3-5 hours and normalizing in 7-10 days. CKMB rises in 4-8 hours and normalizes in 72 hours. Myoglobin is most sensitive for reinfarction.
- Treatment for cardiac issues includes medications like aspirin, beta blockers, ACE inhibitors, and statins, as well as interventions like stents or bypass
o Myoglobin for reinfarct; also CK STEMi positive EKG is (1) ST elevation (2 mm) or (2) LBBB (wide, flat QRS) o Later signs T wave inversion o Old infarct (permanent) Q waves Cardiac enzymes o Troponin I most sensitive; rises in 3-5h, nml by 7-10d o CKMB rises in 4-8h, nml by 72h; also can detect reinfarct after 72h o Myoglobin first to rise (2h) , first to drop (nml by 24h), therefore most sensitive for reinfarction Treatment: MONA (ASA/Clopidogrel), BB Coronary Angiogram determines necessity for intervention o Stent (PCI) pre;ferred o Bypass if (1) left main disease (2) 3 vessel-disease or (3) 2 vesseldisease in diabetic Discharge meds o ASA o Clopidogrel for 9-12m if Stented o BB o ACE-I if CHF or LV Dysfxn o Statin (prevent future disease) o Nitrates (chest pain) Any new angina is deemed Unstable Angina if theres no ST-elevation and normal cardiac enzymes x3 o Next test: Stress test (Exercise EKG) Avoid BB and CCB, c/i: old LBBB, baseline ST-elevation, Digoxin do Exercise Echo instead o in Stress/Exercise test cant be performed, do Chemical Stress Test (Dobutamine or Adenosine) o MUGA (nuclear medicine test) shows perfusion Avoid caffeine and theophylline o Positive if chest pain is reproduced, ST-depression or hyptension occur do Coronary Angiogram Post-MI complications o MCCOD arrhythmia (V. fib worst) o New systolic murmer 5-7d s/p MI AR secondary to papillary mm rupture o Acute severe hypotension vent free wall rupture o Step Up in O2 conc in RA more than RV septal wall rupture o Persistent ST-elevation 1 month later with systolic MR murmer Ventricular Wall aneurysm o Cannon A-waves (in JVP, bounding) AV-dissociation, either V. fib or 3rd degree heart block o 5-10w later, pleuritic chest pain, low grade temp Dressler Syn (autoimmune pericarditis; Rx: NSAIDs and ASA) o Diffuse ST-elevation a/w pericarditis; worsens with inspiration, friction rub, pain alleviates w/ leaning forward