Acute Coronary syndrome Flashcards
What conditions are considered ACS?
Myocardial infarction: NSTEMI and STEMI
Unstable angina
What is treatment for FOUR symptoms commonly experienced in ACS?
- hypoxia- O2
- Ischaemiac pain:
GTN/isosobide dinitrate
IV diamorphine/ morphone with metoclopramide - Reperfusion :
aspirin 300mg and clopidogrel 300mg
Percutaneous coronary intervention (PCI )or thrombolytic
4.To prevent re-occlusion systemic and embolisation:
parenteral anticoagulant
What would you give for longterm management following ACS?
- statin
- ACEi
- Aspirin indefinitely
4.BB - Clopidogrel ( for 4 weeks= STEMI, 12 months =NSTEMI/unstable angina)
What is an example of Percutaneous coronary intervention?
Balloon angioplasty
stent implantation
atherectomy
What medication should given along side PCI?
Dual anti platelet therapy
Aspirin (forever)
Clopidogrel-
Elective=one month
Bare metal stent= 12 months
Drug-electing stent-12+ months
How can a PCI be given?
With Glycoprotein IIb/IIa inhibitor
How are the two types of MIs categorised?
ST-segment elevation STEMI- caused by complete and persisting blockage of the artery.
Non-ST-segment elevation MI NSTEMI-
reflecting partial or intermittent blockage of the artery.
Who are at risk of MI?
Male sex
Older age
socioeconomic status
Geographic location
Lifesytlefactors
Genetics
DM
what complications of MI and why do they occur?
- Acute HF:
hours after MI- stunning, arrhythmia, extensive volume infarction
Days after MI: rupture of a papillary muscle and resulting valvular incompetence
Anytime later:
acute decompensation of chronic HF
- Chronic HF
- Post-infarction angina
- stroke
- depression
- anxiety disorders
7.sudden death
- dressers syndrome
what is the preferred dual anti platelet in patients undergoing PCI?
Aspirin and prasugrel
