Acute coronary syndrome Flashcards
MI Risk factors
Atherosclerosis
Diabetes
Smoking
What is crescendo angina
Rapidly worsening angina
What is unstable angina
It is chest pain at rest
What is stable angina
Is chest pain on exertion
Symptoms of MI
Acute central chest pain (crushing)
Dyspnoea
Sweating
Palpitations
Others:
Epigastric pain
Vomiting
Syncope
When does MI present without pain
In elderly or Diabetics
Signs of a patient with MI
Distress
Anxiety
Pallor
Sweatiness
Tachycardia or Bradycardia
Hypertension
4th heart sounds
HF signs
3 signs of HF
Increased JVP
3rd heart sound
Basal crepitations
How to investigate MI
ECG - @in 20% normal initially
CXR
What do you look for in a CXR when suspecting MI
Cardiomegaly
Pulmonary oedema
widened mediastinum
What blood test would you take in MI
FBC
U&Es
glucose
Lipids
Cardiac troponin
Creatine kinase
Tell me about Cardiac troponin
T and I
increase with 3-12 hours of onset of chest pain
Peak at 24-48 hours
Return to baseline 5-14days
Tell me about Creatine kinase
CK-MB is the one for the heart
others are CK-MM and CK-BB
Increase with in 3-12 hours
peak at 24 hours
Return to baseline at 48-72 hours
Differntials of ACS
Pericarditis
Myocarditis
Aortic dissection
PE
Oesophageal reflux/spasm
Prognosis of MI
50% of death occur within 2 hours of onset of symptoms
7% die before discharge
