High Yield Cardio Topics for Internal Medicine Shelf

Cardio Chest pain: EKG > Cardiac enzymes (3x q8h) Myogloin !or rein!arct" also CK  o #$EMi % positi&e EKG is (') #$ ele&ation ( mm) or () *** (+ide, -at ./#) ater signs % $ +a&e in&ersion o 0ld in!arct (permanent) % . +a&es o Cardiac enzymes  $roponin 1 % most sensiti&e" sensiti&e" rises in 32h, nml y 42'5d 42'5d o  $roponin o CKM* % rises in 628h, nml y 4h" also can detect rein!arct rein!arct a!ter 4h o Myogloin % 7rst to rise (h) , 7rst to drop (nml y 6h), there!ore there!ore most sensiti&e !or rein!arction rein!arction  $reatment:  $reatment: M09 M09 (9#9Clopidogrel), (9#9Clopidogrel), ** Coronary 9ngiogram determines necessity !or inter&ention o #tent (;C1) pre"!erred *ypass % i! (') le!t main disease () <3 &essel2disease or (3) < &essel2 o disease in diaetic =ischarge meds 9#9 o o Clopidogrel !or 2'm i! #tented o ** o 9CE21 i! C?@ or A =ys!xn o #tatin (pre&ent !BtBre disease) itrates (chest pain) o 9ny ne+ angina is deemed Dnstale 9ngina i! theres no #$2ele&ation #$2ele&ation and normal cardiac enzymes x3 o ext test: #tress test (Exercise EKG) 9&oid ** and CC*, ci: old ***, aseline #$2ele&ation, =igoxin  do Exercise Echo instead in #tressExercise test cant e per!ormed, do Chemical #tress $est o (=oBtamine or 9denosine) o MDG9 (nBclear medicine test) % sho+s per!Bsion 9&oid 9& oid caFeine and theophylline o ;ositi&e ;ositi&e i! chest pain is reprodBced, #$2depression #$2depression or hyptension occBr  do Coronary 9ngiogram ;ost2M1 complications o MCC0= % arrhythmia (A 7 +orst) e+ systolic mBrmer 24d sp M1 % 9/ secondary to papillary mm rBptBre o 9cBte se&ere hypotension % &ent !ree +all rBptBre o o #tep DpH in 0 conc in /9 more than /A % septal +all rBptBre o ;ersistent #$2ele&ation ' month later +ith systolic M/ mBrmer % AentricBlar Iall aneBrysm Cannon 92+a&es (in JA;, oBnding) % 9A2dissociation, either A 7 or 3 rd o degree heart loc 2'5+ later, pleBritic chest pain, lo+ grade temp % =ressler #yn (aBtoimmBne o pericarditis" /x: #91=s and 9#9) o =iFBse #$2ele&ation #$2ele&ation % a+ pericarditis" pericarditis" +orsens +ith inspiration, !riction rB, pain alle&iates + leaning !or+ard •

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