Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Y4 - Surgery - Cardiothoracic > Acute Coronary Syndrome > Flashcards

Acute Coronary Syndrome Flashcards

1
Q

ESSENCE

A

Usually result of thrombus from atherosclerotic plaque blocking a coronary artery, this thrombus is is mostly made of platelets

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

3 types of acute coronary syndrome

A
  • Unstable angina
  • ST elevation myocardial infarction (STEMI)
  • Non-ST elevated myocardial infarction (NSTEMI)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

INVESTIGATIONS

First line

A
  • 1) ECG - if ST elevation diagnosis is STEMI
  • 2) Tropnonin blood tests - if raised or ECG changed diagnosis is NSTEMI, if normal and ECG unchanged then unstable angina
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

INVESTIGATIONS

Other investigations

A
  • Chest x-ray - investigate other causes of pain
  • ECHO - assess functional damage
  • CT coronary angiogram - assess for coronary artery disease
  • FBC
  • U&Es
  • LFT
  • Lipid profile
  • TFT
  • HbA1c and fasting glucose
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

CLINICAL FEATURES

Symptoms

A
  • Central, constricting chest pain associated with
    • Nausea and vomiting
    • Sweating and clamminess
    • Feeling of impending doom
    • Shortness of breath
    • Palpitations
    • Pain radiating to jaw or arms
  • Lasts for 20 minutes after rest
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

AETIOLOGY

Risk factors

A
  • Diabetes
  • Hyperlipidaemia
  • Hypertension
  • Metabolic syndrome
  • Renal impairment
  • Peripheral arterial disease
  • History of ischaemic heart disease
  • Obesity
  • Age
  • Smoking
  • Cocaine use
  • Physical inactivity
  • Family history
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

INVESTIGATION

ECG changes in STEMI

A
  • ST segment elevation
  • New left bundle branch block
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

INVESTIGATION

ECG changes in NSTEMI

A
  • ST segment depression
  • Deep T wave inversion
  • Pathological Q waves
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Left coronary artery - heart area and ECG leads

A

Area - anterolateral

ECG leads - I, aVL, V3-6

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Left anterior descending - heart area and ECG leads

A

Area - anterior

ECG leads - V1-4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Circumflex - heart area and leads

A

Area - lateral

Leads - I, aVL, V5-6

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Right coronary artery - heart area and ECG leads

A

Area - inferior

Leads - II, III, aVF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Other causes of raised troponins

A
  • Chronic renal failure
  • Sepsis
  • Myocarditis
  • Aortic dissection
  • Pulmonary embolism
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are troponins

A

Proteins found in cardiac muscle, released when muscle is ischaemic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

MANAGEMENT

Acute STEMI treatment

A
  • Primary PCI (if within 2 hours presentation)
  • Thrombolysis (if PCI not available within 2 hours presentation)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Thrombolysis mechanism

A

Injecting a fibrinolytic medication breaks down fibrin and dissolves clots, significant risk of bleeding

17
Q

MANAGEMENT

Acute NSTEMI treatment

A
  • Remember BATMAN
    • Beta-blockers unless contraindicated
    • Aspirin 300mg stat dose
    • Ticagrelor 180mg stat dose (or clipidogrel if higher bleed risk)
    • Morphine titrated to control pain
    • Anticoagulant (Fondaparinux)
    • Nitrates (GTN)
  • Give oxygen only if saturations dropping <95%
18
Q

Score used to assess for PCI in NSTEMI

A
  • GRACE score
    • Gives 6 month risk of death or repeat MI after having NSTEMI
    • <5% low risk
    • 5-10% medium risk
    • >10% high risk
  • If medium or high then considered for early PCI to treat underlying artery disease
19
Q

COMPLICATIONS

Of MI

A
  • Remember DREAD
    • Death
    • Rupture of heart septum or papillary muscles
    • Edema (heart failure)
    • Arrhythmia and aneurysm
    • Dressler’s syndrome
20
Q

MANAGEMENT

Secondary prevention

A
  • Medical (6As)
    • Aspirin 75mg once daily
    • Another antiplatelet (clopidogrel or ticagrelor for 12 months)
    • Atorvastatin 80mg
    • ACE inhibitor (ramipril)
    • Atenolol (or other beta blocker)
    • Aldosterone antagonist for those with heart failure
  • Lifestyle
    • Stop smoking
    • Reduce alcohol
    • Exercise
    • Diet
21
Q

Types of MI

A
  1. Traditional due to acute coronary event
  2. Ischaemia secondary to increased deman or supply of oxygen (such as anaemia, tachycardia or hypotension)
  3. Sudden cardiac death or arrest suggestive of ischaemic event
  4. Associated with PCI/coronary stunting/CABG

Y4 - Surgery - Cardiothoracic (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions