angiography 4 21

Angiography

Cases

  • atenolol cleared by kidney
  • beta blocker first line because only one prevents MI
  • CCB can be good for vasospastic angina

  • need nitrate free period of 12 hours to avoid nitrate tolerance

  • ranolazine drug drug interaction with cardizem, decrease dose (CYP)

  • PCI

  • CABG because reversible

  • can take SL nitrate as ppx prior to exercise
  • HTN: treat to 130/80, lower = better

  • 6 months total
  • if not having sx can also try to get rid of isosorbide since revascularization is complete

Mahesh lecture

  • JVD from cross room: perhaps V wave and TR.
  • Fredrich’s sign: exaggerated x wave or diastolic collapse of neck veins from constrictive pericarditis
  • Kussmaul’s sign: no high predicative value. Neck vein rise in inspiration
  • pulsus alternans:
    • can be in severe LV heart failure due to alternating squeeze with increased intracellular calcium, moving back and forth on starling curve
  • pulsus bisferiens: squeeze and severe regurgitation with severe AI.

Bradycardia and Syncope