12 - Acute Coronary Syndromes and Stable Angina Flashcards

1
Q
A 62 yo man reports 6 mo of chest discomfort on fast walking. His symptoms occur every time he walks 500 feet and beyond, are associated with SOB and are relieved after few min of rest. What is your most likely clinical diagnosis?
A.Unstable angina
B.Acute coronary syndrome
C.Chronic Stable angina
D.Printzmetal’sangina
E.Pericarditis
F.Aortic dissection
G.Pulmonary embolism
A

c

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2
Q
A 30 yo woman reports sudden onset of sharp chest pain, increasing with deep inspiration and lying in the supine position, and relieved by sitting up. What is your most likely clinical diagnosis?
A.Unstable angina
B.Acute coronary syndrome
C.Chronic Stable angina
D.Printzmetal’s angina
E.Pericarditis 
F.Aortic dissection
G.Pulmonary embolism
A

e

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3
Q

pathophys of chronic stable angina

A

stable plaque causing ischemia upon exertion. usually symptomatic when vessel is at least 70% occluded

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4
Q

4 types of acute coronary syndrome

A

unstable angina
non-st elevation MI
st elevation MI
sudden cardiac death

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5
Q

how long before sustained unstable angina becomes an MI?

A

15-20 min

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6
Q

most reliable biomarker for MI

A

troponin

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7
Q

what is the pathophys difference between MI w/ or w/o ST elevation?

A

w/o - partially occlusive event - 90-99% usually

w/ - complete blockage

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8
Q

difference in initial tx of MI w/ or w/o ST elevation

A

w/o - early invasive strategy + medical tx

w/ - acute reperfusion therapy (immediate cath or fibrinolytic therapy) + medical tx

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9
Q

where does angina usually radiate to?

A

L arm and jaw

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10
Q

medical tx for acute coronary syndromes

A

antiplatelet: aspirin + (oral ADP antag like clopidogrel OR IV glycoprotein 2b/3a inhib)
anticoag: heparin of some form
anti-ischemic - beta blockers + nitrates (or CaCBs)

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