TUTORIAL TUESDAY
This video briefly explains the electrical system of the heart and how a pacemaker works.
MED REVIEW MONDAY: Streptokinase (aka Streptase)
What is it? A thrombolytic drug (it breaks up clots) administered intravenously
How does it work? Plasmin is a blood component that normally acts to break fibrin bonds after a regular blood clot has completed its job in stopping a bleed. Streptokinase increases the production of plasmin so that “bad” clots break up.
When is it used? During an MI to break up blockages in the heart and prevent damage to the muscle tissue, during a pulmonary embolism to break up a clot in the lungs, during an ischemic stroke but NEVER hemorrhagic
What do I need to know about it? Because it’s made from a bacteria material, we develop resistance to it and can have a severe (even anaphylactic) allergic reaction the second time the drug is given. Therefore, it is only indicated during a patient’s first heart attack. TPA is used instead if there is a future need. Do not administer concurrently with an anticoagulant or aspirin. Thrombin time is monitored during use. Heparin therapy should follow the use of Streptokinase.
TRICKY THURSDAY
All People Eat Turkey Meat is the mnemonic I was taught to remember the points of auscultation of the heart.
- All = Aortic
- People = Pulmonic
- Eat = Erb’s Point
- Turkey = Tricuspid
- Meat = Mitral
Also, my personal trick is pretending that I’m the “Z for Zorro” character, and I’m drawing a Z across their chest with my stethoscope.
TRICKY THURSDAY
“One Heart and Two Lungs”
This saying serves as a reminder of Beta receptor activity. Beta-1 receptors are cardiac and Beta-2 receptors are airway.
WOMEN’S HEALTH WEDNESDAY
Go Red For Women ™ presents: ‘Just a Little Heart Attack’
I love this new film. It’s 3 minutes, it’s hilarious, it’s… as serious as a heart attack. Please share this with every woman you know!
Super cool video, but I also think it’s important to acknowledge that for many women, the story does not have such an easy conclusion. Symptoms of a heart attack vary between the genders - a woman may never experience the “classic” pressure in the chest or pain in the left arm radiating to the jaw. Female heart attack symptoms usually include fatigue, nausea and indigestion. And women being women, they often deny the fact that anything is wrong and refuse medical attention - just like this woman did at first in the video.
TUTORIAL TUESDAY
This animation demonstrates angioplasty and the stent placement procedure.
CELEBRITY SATURDAY: The show must go on!
Marfan syndrome is a genetic disorder with a variety of identifiable clinical features. It is passed on through a dominant gene. It strongly affects the development of connective tissue. Signs include:
- Body type: above average height, slender limbs, long fingers and toes.
- Eye problems: myopia (nearsightedness), astigmatism, dislocation of the lens or detachment of the retina.
- Cardiovascular problems: degeneration of the valves, mitral valve prolapse, aortic regurgitation, dilated aorta, aortic aneurysm, poor circulation (resulting in cold hands and feet).
- Lungs: at risk for spontaneous pneumothorax and sleep apnea
- Central Nervous System: dural ectasia (the weakening of the membrane that encases the spinal cord)
There is no cure for Marfan syndrome; just treating each symptom as it arises and monitoring cardiovascular health/other risks.
Jonathan Larson, the playwright responsible for the musical RENT, suffered from undiagnosed Marfan syndrome. He died at age 35 of an aortic dissection the day before opening night of the play.
MED REVIEW MONDAY
Lidocaine (aka xylocaine) is a common drug that has two main uses: a local anesthetic and an anti-arrythmic.
As an anesthetic it has a rapid onset and an intermediate duration; It is commonly used for dental surgeries, inflammation, endoscopies, before intubations or IV insertions.
As an anti-arrythmic drug it is used to treat ventricular arrhythmias (such as PVCs), for digitalis poisoning or during a cardiac catherization.
Other uses include seizures, as an anti-tussive or to treat jellyfish stings.
Some side effects include tinnitus (a ringing in the ear) and paraesthesia (pins and needles), and it is contradicted in patients with pacemakers.
It comes in all different forms: topical creams, skin patch, nasal spray, IV injection, nebulizer, oral injection…
Fun fact: Cocaine dealers often mix lidocaine in their product to fool customers. Since lidocaine numbs on contact the diluted cocaine seems even stronger.
FACTOID FRIDAY: Oral Health Edition
Gum disease allows bacteria to enter your blood stream, putting you at risk for endocarditis (infection of the inner lining of the heart).
Cardiovascular disease may be in part caused by periodontis (chronic inflammation of the gums).
Gum disease has been linked to premature birth and low birth weight.
Losing teeth before age 35 (from natural causes - not a bar fight) is a risk factor for Alzheimer’s disease.
TRICKY THURSDAY
For the treatment of congestive heart failure, think UNLOAD FAST:
U sit Upright
N Nitro
L Lasix
O Oxygen
A Aminophylline
D Digoxin
F Fluids- decrease
A Afterload - decrease
S Sodium - decrease
T Tests: dig level, ABG, K+
