ACS Flashcards
(31 cards)
What are the 3 conditions that come under this
Unstable angina
NSTEMI
STEMI
What happens in unstable angina
There is a partial block in the coronary artery (like STEM)
Reversible
NO necrosis
What happens in NSTEMI
Partial block
Necrosis
STEMI?
Complete blockage is coronary artery
Necrosis
What test is used to differentiate between unstable angina and NSTEMI
Troponin
If increased = most likely NSTEMI
Troponin?
Protein found in the heart muscles
When heart muscle is damaged it is released into the bloodstream
What other tests
ECG
Creatinine (high levels)
What are the presentations
Chest plain
Sweating
N&V
Before admission, during the journy to hospital what should be given in all ACS cases
MONA
What are the initial management of NSTEMI/unstable angina
300mg Asiprin (loading dose)
+
Fondaparinux (unless immediately angiography) or UH if renal impairment
To decided the next step of treatment a risk score will be made
What is this called
GRACE
If 3% and under - mortality within the next 3 months, what to give?
Ticragrelor + aspirin
If bleeding risk
Clopidogrel + aspirin
Or aspirin alone
If score is over 3 what to do?
Angiography then PCI within 72 hours
Which antiplatlets are given in combo with aspirin
Ticagrelor or prasurel + aspirin
If on anticoagulant give clopidogrel with it (eg Rivaroxaban)
High bleeding risk - Aspirin alone
If aspirin carnt be taken then Clopidogrel alone
When can you only give prasgurel
When PCI is intended
When undergoing PC what needs to be given
UH
What should be given for hyperglycemia
Iv insulin
How long is antiplatlet therapy continued for
12 month
Aspirin to be continued indefinitely
STEMI management
What is initial treatment
300mg loading dose Aspirin
What are the 2 options
PCI or fibrinolysis
Who can be given PCI
If it can be done within 120 mins and they arrive within 12hrs of presentation
What is the drug therapy with those for PCI
Prasugrel + aspirin
If on anticoagulant- clopidogrel + aspirin
Next,
What is given for fibrinolysis
Streptokinase
