Accute Coronary Syndrome Flashcards
(14 cards)
What does Acute Coronary Syndrome (ACS) refer to?
A spectrum of clinical conditions caused by a sudden, reduced blood flow to the heart muscle due to atherosclerotic plaque rupture and thrombus formation
Results in myocardial ischemia and can lead to infarction if not promptly treated.
What are the three classifications of Acute Coronary Syndrome?
- Unstable Angina (UA)
- NSTEMI (Non-ST Elevation Myocardial Infarction)
- STEMI (ST Elevation Myocardial Infarction)
Each classification has distinct diagnostic criteria and implications for treatment.
Define Unstable Angina (UA)
Ischemic symptoms without elevated cardiac biomarkers or persistent ST changes
Typically involves chest pain without definitive evidence of myocardial infarction.
What characterizes NSTEMI?
Biomarker elevation without ST-segment elevation; partial-thickness infarction
Indicates myocardial damage but not complete blockage.
What defines STEMI?
ST-segment elevation plus biomarker elevation; full-thickness myocardial infarction
Represents a more severe form of myocardial infarction.
What are common clinical features of ACS?
- Intense, pressure-like chest pain (>20 min)
- Radiating pain to the arm, jaw, or back
- Diaphoresis
- Nausea
- Vomiting
- Anxiety
- Palpitations
- Dyspnea
Elderly and diabetics may present with atypical symptoms such as fatigue or syncope.
What are the key diagnostics for ACS?
- ECG (within 10 minutes)
- Serial troponins
- Echocardiography
- Chest X-ray
- Coronary angiography
These tests help confirm diagnosis and assess severity.
What does the acronym MONA stand for in the initial stabilization of ACS?
- Morphine
- Oxygen
- Nitrates
- Aspirin
This combination is used for immediate management of chest pain.
What is the role of high-dose statins in ACS treatment?
To reduce cholesterol levels and stabilize atherosclerotic plaques
Atorvastatin is a common example.
What is Dual Antiplatelet Therapy (DAPT)?
Combination of aspirin + P2Y12 inhibitor (clopidogrel, ticagrelor, or prasugrel)
DAPT is essential for preventing further thrombotic events.
What anticoagulants are used in ACS management?
- Unfractionated heparin
- Enoxaparin (LMWH)
- Bivalirudin (direct thrombin inhibitor)
These agents help prevent further clot formation.
What is the recommended reperfusion therapy for STEMI?
PCI within 90 minutes or fibrinolysis (e.g., alteplase) if PCI is unavailable
Timely reperfusion is critical to minimize heart damage.
How is NSTEMI/UA treated?
Risk stratification guides the choice between invasive vs conservative approach
Treatment is tailored based on the patient’s risk profile.
What are key components of secondary prevention after ACS?
- Cardiac rehabilitation
- Blood pressure control (e.g., ACE inhibitors like ramipril)
- Glucose control
- Smoking cessation
These measures aim to reduce the risk of future cardiovascular events.
