Acute Coronary Syndromes Flashcards
(30 cards)
which three conditions come under the umbrella term of ACS
unstable angina
STEMI
NSTEMI
which condition predisposes patients to developing ACS
angina
what is the pathophysiology of unstable angina
plaque rupture or fibrous cap erosion causing reduced coronary blood flow - can cause partial or complete occlusion by thrombus
what are the symptoms of unstable angina
central stabbing chest pain possibly with radiation
pain felt upon rest
dyspnoea
what investigations are carried out for unstable angina
ECG - may be normal
cardiac enzymes to rule out MI
what is the treatment for low risk patients with unstable angina
aspirin and clopidogrel
nitrates
what is the treatment for high risk patients with unstable angina
MONAC
revascularisation
what is myocardial infarction
death of myocytes due to partial or complete occlusion of blood vessel due to thrombus
what are the symptoms of MI
new onset of severe central chest pain at rest
radiating to jaw, neck, left arm
breathlessness
associated with nausea, sweating, vomiting
what investigations are carried out for MI
ECG
cardiac troponins (T and I)
exercise ECG
what are the possible findings on ECG of an NSTEMI
ST depression, T wave inversion, Q waves
how long are cardiac troponins elevated for
7 days
is myocyte death from a STEMI reversible
no
what are the ECG findings of a STEMI
ST elevation
T wave inversion
Q waves
for a diagnosis of STEMI where must the ST elevation be present
> 1mm elevation in adjacent limb leads
>2mm elevation in consecutive precordial leads
an anterior MI affects which leads
V2-6
an anterolateral MI affects which leads
V4-6, aVL
an anteroseptal MI affects which leads
V1-3
an inferior MI affects which leads
II, III, aVF
a posterior MI affects which leads
V1-2
what is the immediate treatment for a STEMI
Morphine + anti-emetic Oxygen Nitrates Aspirin chewed Clopidogrel oral gel
what class of drug are aspirin and clopidogrel
anti-platelets
what is the first line treatment for acute STEMI
PCI
what is the time frame for PCI from developing symptoms
90 minutes
