CARDIOLOGY

Recall the clinical and laboratory manifestations of an acute ventricular septal defect.

Explanation:

About 3-7 days post MI a patient who goes into sudden cardiogenic shock and has a new holosystolic murmur in an area other than the mitral area-best heard in the parasternal area. Confirm the diagnosis by using echo with doppler or by inserting a swan Ganz catheter to see a step up of oxygen saturation from RA to RV by more than 5%.

CARDIOLOGY

Identify Dressler's syndrome

Explanation:

Dressler's syndrome or Post MI syndrome occurs few days to upto 6 weeks after an MI.

It presents with fever and pleuropericardial chest pain.

Salicylates are drugs of choice. Glucocorticoids may be used in cases not responding to Salicylates. Do not give anticoagulants.
 

CARDIOLOGY

Recall the prognostic indicators that influence survival following myocardial infarction.

Explanation:

LV ejection fraction is the most important prognostic indicator.

Another important indicator is presence of ischemia in an area other than the infarct area(ischemia at a distance).

Ventricular arrhythmias within 48 hours of the MI do not impact the outcome but those later than that do.

More to be added