13 Cardiovascular disease
Questions
What is the role of amiodarone in the acute management of asystole or pulseless electrical activity (PEA)?
What are the possible causes of atrial extrasystoles, in a patient with a normal echo, which last for several days and then disappear spontaneously? Is treatment with anxiolytics recommended?
How safe is it to stop administration of carvedilol to a patient with heart failure? Can the drug be tapered off? What are the effects/dangers of stopping carvedilol suddenly? What, if any, are the reasons for discontinuing carvedilol in patients with heart failure?
There have been a number of recent publications concerning aspirin versus warfarin trials. Would you recommend prescribing warfarin for secondary prevention of coronary heart disease in patients suffering from their first myocardial infarction (MI)?
Is there any benefit in combining aspirin with clopidogrel in post-MI angina and ischaemic stroke? A MATCH trial showed this combination not to be of benefit – would you therefore recommend we stop using this combination in our hospital unit?
You have said that in IV drug users the microbes go directly to the right ventricle, thus causing endocarditis in the right heart. But in dental xCardiovascular disease procedures the microbes also go through the veins to the right heart first, so why are the left heart valves more commonly affected?
In the treatment of hypertension, is it recommended to commence treatment with two drugs containing a thiazide (if elderly) or a beta-blocker (if young)?