ACS part 1 Flashcards
spontaneous MI
atherosclerotic plaque rupture
MI secondary to ischemic imbalance
oxygen supply or demand mismatch to heart (vasospasm, anemia, hypotension)
T or F: Women are more likely to have ACS than men
F, men more likely
signs and symptoms of ACS
NV, diaphoresis, SOB
atypical symptoms of ACS
epigastric pain
indigestion
stabbing or pleuritic pain
increasing dyspnea in absence of chest pain
how fast should a pt with acute chest pain get an ecg after arrival to the ER
10 min
ECG STEMI (slide)
- q wave changes
- often not present on initial ecg, but develops over hours to days
- electrica ‘hole’- scar tissue cannot conduct electricity
- may disappear after early reperfusion if stunned tissue can recover
- often remain permanently
ECG NSTEMI and UA
- may have normal ECG
- ST depression, new T-wave inversion
- Q wave changes unlikely
- NO ST ELEVATION
if you see inverted T wave what do you assume
NSTEMI
what is the second thing you should do at hospital after getting ECG?
troponin levels
talk about troponin
-protein released into blood during heart attack
- released from necrotic myocytes
- gold standard
- high sensitivity (preferred), measured in ng/L
- conventional measured in ng/ML
troponin:
normal value is undetectable
high sensitivity troponin: < __
conventional troponin: < __
high: 14 ng/L
conventional: 0.05ng/mL
talk about troponin monitoring (2 things)
-need to check troponin at least 3 times in 12 hours
-initial test may be negative
stable angina info from slide
- chest pain occurs during physical exertion
- predictable
- relieved by rest
- lasts a short time (<5 min)
unstable angina info from slide:
- chest pain may occur at rest, while sleeping, or with little physical exertion
- comes as a surprise
- more severe and lasts longer than stable angina
