Showing posts with label Cardiowesome. Show all posts
Showing posts with label Cardiowesome. Show all posts

Wednesday, November 10, 2021

Treatment of myocardial infarction associated pericarditis


Hi everyone! There are two types of myocardial infarction associated with pericarditis. Let
s learn more about the management!

Early infarct-associated pericarditis: Occurs 1 to 3 days after transmural myocardial infarction (because of the interaction of the healing necrotic epicardium with the overlying pericardium). 
Late post-myocardial infarction pericarditis (Dressler’s syndrome): Occurs weeks to months after myocardial infarction. 

Initial therapy includes high-dose aspirin (650 to 1,000 mg every 6 to 8 hours).
Proton pump inhibitor (PPI)  - improves the gastric tolerability of the aspirin. 
Acetominophen can be added for pain management.

Dosing of aspirin:
Initial: 650 mg to 1 g every 8 hours until resolution of symptoms for at least 24 hours and normalization of inflammatory biomarkers (eg, C-reactive protein). A treatment period of one to two weeks before tapering is usually sufficient. 
Taper: Decrease each dose by 250 to 500 mg every 1 to 2 weeks. Ensure patient remains asymptomatic and inflammatory biomarkers are normal. 

There is no published experience on the use of colchicine in peri-infarction pericarditis. Colchicine may reduce the need for pericardiocentesis or other pericardial interventions and is usually given at a dose of 0.6 mg twice daily for a month, or longer if the patient has a recurrence of symptoms.

Why are NSAIDs such as ibuprofen avoided in the peri-infarct period?
Interferes with the antiplatelet aggregation effects of aspirin. 
Interferes with myocardial healing.
PS: Acetominophen does not affect the coagulation system and can be used.

References:

-IkaN (Nakeya Dewaswala)

Monday, November 1, 2021

Normal P wave ECG notes and mnemonic

Here is the video:

 

Mnemonic:

Notes:
Sinus P waves
Axis: 0 and +75 degrees
Upright: Leads I, II, V5, V6
Inverted: aVR
Duration: <120ms or 3 small squares
Amplitude:
Limb leads: < 2.5 mm (0.25mV)
Precordial leads: < 1.5 mm (0.15mV)

-IkaN

Determining pacemaker type from EKG (RV pacing vs biventricular pacing)

 Hello, cardiowesomites!

Today we are going to learn how to determine pacemaker type from EKG (RV pacing vs biventricular pacing)


Notes:

Thursday, October 21, 2021

LV aneurysm: Difference between true LV aneurysm and LV pseudoaneurysm

LV aneurysms are most commonly caused by myocardial infarction. What's the difference between true aneurysm and pseudoaneurysm?

Thursday, October 14, 2021

Types of pulmonary hypertension mnemonic

Here are my notes and a video on types of pulmonary hypertension - WHO classification! It comes with a mnemonic :)

Saturday, September 18, 2021

SYNTAX score mnemonic

In the SYNTAX (Synergy between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery) trial, patients with 3-vessel and left main coronary artery disease (LMCAD) treated with coronary artery bypass graft surgery (CABG) compared with percutaneous coronary intervention (PCI) with first-generation drug-eluting stents (DES) had lower 5-year rates of death, myocardial infarction (MI), stroke, or unplanned revascularization.

Friday, May 28, 2021

A cardiologist and infectious disease specialist discuss their favorite statin

Cardiologist: What's your favorite statin? Atorvastatin? Rosuvastatin? 
Infectious disease specialist: Cilastatin! 

I onced misspelled it as cilastin and this joke was inspired. Idea credits to Randy Bornmann!