Acute coronary syndromes Flashcards Preview

Cardiovascular System > Acute coronary syndromes > Flashcards

Flashcards in Acute coronary syndromes Deck (19):
1

What are the different acute coronary syndromes?

Unstable angina

STEMI

NSTEMI

2

What is present on an initial ECG and an ECG at 3 days for complete coronary occlusion?

ST elevation then Q waves

- Hyperacute T waves

3

What is present on an initial ECG and an ECG at 3 days for partial coronary occlusion?

No ST elevation then No Q waves

- ST depression
- T wave inversion
- May be normal

4

What is the main example of chronic ischaemic heart disease?

Stable angina

5

How do you diagnose MI?

Detection of cardiac cell death
- Positive cardiac biomarkers (TROPONIN)

- Symptoms of ischaemia
- New ECG changes
- Evidence of coronary problem on coronary angiogram or autopsy
- Evidence of new cardiac damage on another test

6

What are non-cardiac causes of troponin rise?

- Pulmonary embolism
- Sepsis
- Renal failure
- Sub-arachnoid haemorrhage

7

What are the different types of MIs?

Type 1
Type 2
Type 3
Type 4a
Type 4b
Type 5

8

Which arteries correspond with inferior, anterior and lateral MI?

Right coronary artery = Inferior MI

Left anterior descending coronary artery = Anterior MI

Circumflex coronary artery = Lateral MI

9

What are common causes of cardiac chest pain?

Coronary artery disease
Aortic valvular disease
Pulmonary hypertension
Mitral valve prolapse
Pericarditis
Idiopathic hypertrophic subaortic stenosis

10

What are cardiac risk factors?

Male
Age
Known heart disease
Hypertension
High cholesterol
Diabetes
Smoker
Family history of premature heart disease

11

What are treatments for ACS?

Reperfusion therapy: Mechanical, primary PCI or pharmacological

- Angioplasty
- Thrombolysis (tenecteplase)

12

What are investigations to carry out?

- Serial ECGs: consider posterior leads
- Blood tests: check not anaemic, check kidney function, cholesterol, thyroid

13

If patient has more chest pain what can you give them?

Glycerol trinitrate (GTN)
- Vasodilator, opens up coronary arteries
- Can give sub-lingual or as intravenous infusion

Opiates (e.g. morphine)
- Helps relieve anxiety too
- Also helps venodilate

14

Antiplatelet drugs used

Aspirin

Clopidogrel

Ticagrelor

15

Anti-thrombotic drugs used

Heparin

LMWH

Fondaparinux

16

Other pharmacology used

Beta blockers

Statins

ACE inhibitors

17

What are risks of coronary angiography/angioplasty/stenting?

Bleeding
Blood vessel damage
Myocardial infarction
Coronary perforation
Stroke
Dye can affect kidneys

18

What are complications following an MI?

Arrhythmia
Mechanical:
cardiogenic shock
myocardial rupture
Valve dysfunction due to papillary muscle dysfunction/rupture
Acute ventricular defect

19

What should you do pre-discharge for ACS?

Check on correct medications
Address risk factors
Cardiac rehabilitation
Follow-up plans