ACS Flashcards
1
Q
Thrombolysis criteria (3)
A
ST elevation - >1 mm in 2+ limb leads - > 2 mm in 2+ chest leads LBBB Posterior changes in V1-V3 - deep ST depression - tall R waves
2
Q
Thrombolysis contraindications
A
Prev. Intracranial haemorrhage Ischaemic stroke < 6m ago Cerebral malignancy Recent major trauma < 3 wks GI bleed < 1 m Bleeding disorder Aortic dissection Non compressible punctures (LP, biopsies) <24 hrs
3
Q
Thrombolysis alternatives
A
Fondaparinux
Enoxaparin/ unf. Heparin
4
Q
Diagnosis of ACS
A
Increased cardiac biomarkers
- troponin in >50 intermediate risk of MI and > 100 high risk of MI
- creatine kinase at admission and at 12h
ECG changes ( ST el., LBBB, hyperacute T waves)
5
Q
MI complications
A
D-death A-arrhythmia R-rupture T-tamponade H- heart failure V-valve disease A-aneurysm p of ventricle D-dessler's syndrome (pericarditis) E- thrombo-embolism R- recurrence/ mitral regurg
6
Q
STEMI immediate treatment
A
Morphine + anti-emetic (cyclizine) Oxygen (sats <95%) Nitrates Aspirin (300 mg chewed) Clopidogrel/prasugrel (600/60 mg loading)
7
Q
STEMI definitive treatment
A
PCI (within 2 hrs)
- symptoms onset within 12 hrs
Thrombolysis (if PCI not available)
