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Flashcards in 100114 acute coronary syndromes Deck (10):

acute coronary syndrome-most important distinction to make between types?

one that causes ST elevation on ECK (this would be a STEMI) and those that do not (unstable angina, NSTEMI)


clinical cardiac findings for MI

S4 (and S3 if systolic dynsfxn is present) gallop

dyskinetic bulge in anterior wall MI

systolic murmur (if mitral regurgitation or ventricular septal defect)

review other findings on slide


Q waves

sign of transmural infarct


ECG abnormalities for unstable angina/NSTEMI

ST segment depression and/or T wave inversions

may be transient and correlate with chest pain in the case of unstable angina, or persist in the case of NSTEMI


ECG abnormalities of STEMI

initial ST segment elevation, followed over the course of hours by inversion of the T wave and Q wave development (if no treatment)

Q wave persists for weeks (if no treatment)


serum markers of infarction

rise above a threshold level with NSTEMI and STEMI

cardiac troponins (cTnl, cTnT)
creatinine kinase


symptoms of UA vs NSTEMI vs STEMI

UA: crescendo, rest, or new-onset severe angina
NSTEMI and STEMI: prolonged crushing chest pain; more severe and wider radiation than usual angina


critical difference in appraoch to treating pts with STEMI vs UA/NSTEMI

pts with STEMI typically benefit from immediate reperfusion therapies whereas pts with NSTEMI do not


most important predictor of post-MI outcome is

extent of left ventricle dysfxn


standard post-discharge therapy for MI

beta blocker
HMG-CoA reductase inhibitor
ACE inhibitor (if LV dysfxn)