Acute Coronary Syndrome Flashcards
What is the definition of ACS?
What are the 3 types?
patients in whom there is a suspicion or confirmation of acute myocardial ischemia or infarction d/t ↓ O2 Supply &/or ↑ Demand
3 types of ACS
NSTEMI
Unstable angina
STEMI
How would ACS be described?
Progressive atherosclerosis w/ plaque rupture…blood clot…interruption or imbalance of O2 supply & demand
What determines if a patient is having Unstable angina vs a NSTEMI?
sensitivity of the biomarker test (usually troponin) used to evaluate patients with ACS determines whether a patient is labeled as having UA or NSTEMI.
What are the causes of Myocardial damage?
CAD (Caused by endothelial dysfunction; Myocardial O2 demand > O2 delivery)
Cardiac cells can remain viable to 20 minutes in ischemic conditions
What does the Septal/anterior lead show on the ECG?
What does the inferior lead show on the ECG?
(S/A–> V1-V4; L-main—Left coronary artery feeds superior/lateral)
I–> II. III, VF (Right coronary artery feeds inferior)
Left coronary artery feeds superior/lateral
What is the treatment for STEMI?
HINT: MONA BASH-C
Reprefusion (if PCI is not available within 90-120 mins) TEST Q
Anti-platelet (ASA-81mg; Plavix)
Anti-coag (Heparin)
Nitro (decreases myocardial O2 consumption)
Supp. O2 (only if O2 stat <94%)
What is important about beta blockers post-PCI?
How many meds will the patient normally leave the hosptial with? HINT: 5 things
They prevent sudden cardiac death (TEST Q)
(ASA-81mg, ACE, Beta blocker, Statin, Plavix)
What type of line should be used with Vasopressors?
Central line
Peripherial lines cannot handle pressors
What electrolyte distrubance is common with patients on ACE inhibitors, ARBs, or aldosterone receptor blockers?
HINT: Diuretics (have to watch with also)
Hyperkalemia (potassium)
A patient with a past medical hx (PMH) of unstable angina is complaining of chest pain. What is the most concerning finding?
Diaphoresis
Elevated cardiac markers
SOB
ST elevation
ST Elevation
What should the patient be educated on reagarding post-CABG?
Meds: ASA, BB
No lifting over 5lbs for 6wks and No driving for 6wks
What is the difference between Stable and Unstable angina?
Stable: is d/t exertion and the chest pain should be relieved with rest and doesn’t last for more than 10 mins; nitro does not relieved the CP
Unstable: increasing frequency/time/duration, NOT relieved with rest
What should happen if patient is having a STEMI?
EMERGENCY!
GO STRAIGHT TO THE CATH LAB for immediate reprefusion (opening of the coronary artery) within 90mins (GOAL) `
Anginal Pain (CP)> 20mins and often present as indigestion and described as vague or pressure
What is the reason people experience Chest pain?
Decrease delivery of O2
