Acute Coronary Syndrome Flashcards
(50 cards)
Which ward should patient’s diagnosed with ACS be admitted to as soon as possible?
Coronary Care Unit - ccu
What causes ACS?
atherosclerosis - plaque ruptures and thrombus formation
What should be considered when proving information and support to a patient with ACS?
• Patients will be anxious
• A warm welcome from staff is important to establish a
therapeutic relationship
- Sufficient information to understand their diagnosis and treatment plan
- A personalised approach
- Managing realistic expectations from patient & family
- If chest pain assess/ Differential diagnosis
When treating a patient with chest pain what should you treat for first?
The most serious case - myocardial infarction
What protein causes localised vassoconstriction?
Thromboxane A2
What is Acute coronary syndrome (ACS)?
An acute coronary syndrome represents a
combination of clinical signs and symptoms that
result from myocardial ischaemia
What would be the condition of a person with a stable intact lesion?
stable angina
What would be the condition of a patient with breached endothelium with or without superimposed fibrin clot and
coronary spasm?
ustable angina
What would be the condition of a patient with Plaque rupture with superimposed fibrin clot leading to total coronary
occlusion and coronary spasm?
myocardial infarction
What factors make a thorough cardiac assessment?
- Patients require a detailed clinical assessment including ABCDE
- ECG
• Repeat 12 lead ECGS if diagnostic
uncertainty or any change in clinical status
• Continuous cardiac monitoring
When presented with a patint with chest pain what type of questions should be considerdered or factors?
- History of current problem
- Onset
- What makes symptoms better/worse
- Maybe stable angina
- ACS
- Unstable angina
- Acute myocardial infarction
Suggest some contributory factors for ACS
- Age
- S
- FH or CHD
- Prior hx IHD
- Diabetes mellitus
- Renal impairment
- High risk features
- Worsening angina
- Prolonged pain> 20mins in duration
- Pulmonary oedema
- Hypotension
- Arrhythmias
Suggest some risk factors for ACS
- Smoking – mortality 60% higher in smokers
- Hypercholestraemia
- Diet – 1/3 of men & women consume 5 portions fruit & veg
- Sedentary lifestyle 5 x 30mins week
- Alcohol consumption
- Hypertension
- Obesity
- Socioeconomic deprivation
- Diabetes
How does alcohol consumption increase risk of ACS?
induces slight hypertension which increases risk of damage to endothlium
What protective mechanism do pre-menopusal woman have against ACS?
oestrogen
What mnemonic should be used to assess patient chest pain?
PQRST
What does PQRST stand for?
P = Precipitating factors Q = Qualitative factors R = Region & Radiation S = Severity & associated symptoms T = Timing
What would assessment would you expect from an unstable angina?
P = Q = Pressing, squeezing R = Across Chest,jaw, shoulders, back, arms S = Mild to moderate T = 1-20mins
What would assessment would you expect from a Myocardial infarction?
P = Q = Tight, heavy, burning R = Across Chest,jaw, shoulders, back, arms S = Not always severe T = 20 mins-several hrs
What would assessment would you expect from a dissecting aortic aneurysm?
P = Q = Ripping, tearing R = Anterior chest,radiating to neck,back or abdomen S = Very severe T = Abrupt onset Pesistent for hrs
When assessing the type of chest pain what should you ask the patient?
- Pain
- What’s the position of pain
- Radiation
- Quality
- Circumstances
- Time span
- Relief
- Pain score
what obs should be assessed in particular in a patient with chest pain?
- Blood pressure
- Heart rate
- Temperature
What scale is used to assess severety for patients with heat failiure?
New York Heart association classification of heart failiure
When visually inspecting a patient,what factors you consider
• Does the patient look unwell • Colour • Signs of shock • Weight loss • Look at the face – pain, xanthelasma, thyroid disease • Hands • Chest – breathing • Oedema
