ACS Flashcards
(13 cards)
What are the 3 acute coronary syndromes?
Unstable angina
NSTEMI
STEMI
What is the typical clinical presentation for ACS?
- chest pain
- associated symptoms
- risk factors
What is ACS chest pain
- cardiac in nature - central, crushing, radiating to arm/jaw
- more than 30 min, less than 12hrs
- may be alleviated by sitting upright
Associated symptoms of ACS
- sweating
- pallor
- breathlessness
- feeling of impending doom
- presence of risk factors
Risk factors for ACS
- male
- older
- family history
- known atherosclerotic disease /angina
- HTN
- high cholesterol
- DIABETES MELITUS
- RENAL INSUFFICIENCY
Which groups are more likely to present atypically?
- women
- elderly
- diabetics
- renal disease
- peri operative
In groups that are likely to present atypically, what is an important presentation?
- no chest pain
- BREATHLESSNESS
What to remember about ACS pain and indigestion?
Pain may be mistaken as indigestion
Nausea, vomiting, belching may all accompany ACS - do not use to differentiate
How to distinguish the 3 acute coronary syndromes via investigation?
STEMI - ST elevation/ new LBBB on ECG
NSTEMI - raised troponin, no ST elevation
Unstable angina - no ST elevation, no serum troponin
What does raised troponin plus ST depression indicate?
High risk of further event / cardiac death
What increases with troponin levels?
Risk of future event
What else can cause troponin elevation?
Other life threatening conditions presenting with chest pain:
- PE
-aortic dissection
- myocarditis
Plus:
Arrhythmias
Heart failure (acute or chronic)
Sepsis (acute)
Chronic renal failure
Why is an echo performed in the acute setting?
Assess damage to the heart, guide prognosis and treatment
