ACS

Question 1

What are the contraindications to initiation of B blocker?

Answer 1

• signs of acute HF or cardiogenic shock
• AV block w/ PR interval > 0.24s
• 2 or 3rd degree block w/o a pacemaker
• active asthma or reactive airway disease

Question 2

Definition of Type 1 ACS?

Answer 2

• Troponin rise and fall with at least one value > 99th percentile, delta 20% change
• symptoms consistent with myocardial ischemia, or
• new regional wall abnormalities on echo, or
• new ischemic changes on EKG
• must be evidence of plaque rupture

Question 3

Initial management of ACS?

Answer 3

• ischemic directed therapy until cath, incl.
• DUAT; ASA and brillinta
• anticoag; fonda
• high intensity statin
• b blocker
• ace/arb