prostacyclin analogues:
treprostinil, iloprost
endothelin receptor
antagonists: bosentan,
ambrisentan
phosphodiesterase
inhibitors: sildenafil
In most people, which
coronary artery supplies
the AV node?
Right
Bleeding on dabigatran?
Idarucizumab can
reverse
First line investigation
for stable chest pain of
suspected coronary
artery disease
aetiology?
Contrast-enhanced CT
coronary angiogram
Drug eluting stent - what
is of paramount
importance for 12
months?
DAPT
Delay routine surgery
etc
Aminophylline effect on
adenosine?
Which drug should be
avoided in VT?
Verapamil
Risk of VF - blocks AV
node
(hence why verapamil
and B blockers don't go
together)
How can you determine
between: Jervell-Lange-
Nielsen syndrome and
Romano-Ward
syndrome?
Both long QT
JLN - deafness (K+
channel problem)
RW - no deafness
HTN not controlled on
just an ACE inhibitor?
Add CCB or a thiazide
LIKE diuretic eg
Indapamide (preferable
to an actual Thiazide)
Treatment for heart
failure with LV failure?
ACE inhibitor and B
blocker, reduces after
load
DVLA advice for the
heart?
CABG 4 weeks
MI 4 weeks unless successfully
treated by angioplasty then 1
week
Elective angiogram 1 week
ICD: 6 months if for VT
1 month if prophylactic
Heavy goods never again
PPM 4 weeks
Pansystolic murmur
worse on inspiration?
When do you see this
valvular abnormality?
Tricuspid regurgitation
Happens in Ebsteins
anomaly (+WPW)
Takayasu arteritis
Granulomatous (giant cell)
inflammation of media and
adventitia of large elastic
arteries.
Most often affects thoracic
aorta and its proximal
branches and pulmonary
arteries.
If > 55 how useful is the
PERC score?
No - cant use after 55 yrs
of age
All patients post MI?
dual antiplatelet therapy
(aspirin plus a second
antiplatelet agent)
ACE inhibitor
beta-blocker
statin
Chest pain post initial MI
- which blood test?
CK-MB is useful to look
for reinfarction as it
returns to normal after 2-
3 days
(troponin T remains
elevated for up to 10
days)
Why does
ticagrelor/dypridamine
cause dyspnoea
due to the impaired
clearance of adenosine
(adenosine shouldn't be
given in asthmatics)
Treatment of PE?
DOAC!
LMWH in renal
impairment
In antiphospholipid -
LMWH then VKA
Length of treatment for
PE?
DOAC
- 3 months provoked
- 6 months unprovoked
First line treatment of
HTN in diabetics?
Hypertension in
diabetics - ACE-
inhibitors are first-line
regardless of age
Driving rules with ICD
insertion?
if implanted for sustained
ventricular arrhythmia:
cease driving for 6 months
if implanted prophylactically
then cease driving for 1
month. Having an ICD
results in a permanent bar
for Group 2 drivers
AF and cardioversion?
< 48 hours: heparinise and DC
cardiovert in ED or medical with
amiodarone (structural heart
disease) or flecainide in normal
heart
> 48 hours: heparinise for 3 weeks -
cardiovert - heparinise 4 weeks
(if high risk for failure then 4 weeks
amiodarone before cardioversion)
Treatment of HOCM?
Amiodarone
Beta-blockers or
verapamil for symptoms
Cardioverter defibrillator
Dual chamber
pacemaker
Endocarditis prophylaxis
HOCM gene?
the gene encoding β-
myosin heavy chain
protein or myosin
binding protein C
Causes of infective
endocarditis after dental
work?
Streptococcus mitis and
Streptococcus
sanguinis.
MOA of dipyridamole
Non-specific
phosphodiesterase
inhibitor and decreases
cellular uptake of
adenosine
Inhibits platelet
aggregation