Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Junior Medicine- Cardiology > Acute Coronary Syndromes > Flashcards

Acute Coronary Syndromes Flashcards

1
Q

What are the acute coronary syndromes?

A
  • Unstable angina
  • NSTEMI
  • STEMI
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the risk factors for ACS?

A
  • Age
  • Male sex
  • CVD e.g. HTN, atherosclerosis
  • Smoking and alcohol
  • Sedentary lifestyle and obesity
  • FHx
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What does the Left Coronary Artery divide into?

A
  • Left circumflex
  • Left anterior descending
  • Left marginal (anterior branch of the Left Circumflex)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What does the right coronary artery divide into?

A
  • Right marginal

- Right posterior descending

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Which leads show the Left Circumflex Artery?

A

I, aVL, V5, V6

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Which leads show the Left Anterior Descending?

A

V1-V4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Which leads show the Right Marginal?

A

I, II, aVF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Which areas of the heart are supplied by the Left Circumflex?

A
  • LA

- Posterolateral LV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Which areas of the heart are supplied by the Left Marginal?

A

Left Ventricle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Which areas of the heart are supplied by the Left Anterior Descending?

A
  • Anterior LV (majority of LV supply)
  • Apex
  • Interventricular septum
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Which areas of the heart are supplied by the Right Marginal?

A
  • Right ventricle

- Interventricular septum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Where does the Posterior Descending artery originate?

A
  • Usually (70%) from the RCA

- Some come from the left circumflex artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What ultimately drains the arteries’ deoxygenated supply?

A

Coronary sinus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Describe the pathophysiology of ACS.

A

Occlusion of the coronary arteries

  • Ruptured plaque/thrombus occluded the coronary artery(s)
  • Ischaemic damage from hypoxia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How would ACS present?

A
  • Central crushing/visceral pain
  • Radiation to jaw or arm
  • Sympathetics- N&V, sweating, palpitations
  • Dyspnoea
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is a silent MI and who gets them?

A

Diabetics

- MI without chest pain

17
Q

What signs might you see on examination?

A
  • Tachycardia
  • Dyspnoea
  • Tachypnoea
18
Q

What timeframe of symptoms would you consider for ACS?

A
  • Symptoms at rest for 20+ minutes

- If less than 20 minutes, consider stable angina

19
Q

What bloods would you do for ACS?

A
  • Troponin- baseline, 3-6 hours, 12 hours
  • CK-MB
  • Full profile
20
Q

What imaging is useful in ACS?

A
  • CXR - cardiomegaly may occur, will also show other differentials such as MSK and pneumonia
  • ECHO - post-MI function of the heart
  • CT coronary angio
21
Q

What might an ECG show for a STEMI?

A
  • ST elevation

- New LBBB

22
Q

What might an ECG show in an NSTEMI?

A
  • ST depression
  • T wave inversion
  • Q waves if late presentation
23
Q

What score is used for risk of death and recurrence in NSTEMI?

A

Grace Score- 6 month risk

24
Q

Outline the Grace Score.

A

<5% Low risk

5-10% Moderate risk

10+% High risk

25
Q

Who gets PCI according to the Grace Score and when?

A
  • Moderate and high risk patients (5%+)

- Within 4 days of admission

26
Q

What lifestyle changes may be made for ACS?

A
  • Weight loss and exercise
  • Low sodium diet
  • Smoking cessation and alcohol advice
  • Cardiac rehab
  • Optimise co-morbidities
27
Q

Which diet is good for ACS?

A

Mediterranean

28
Q

What medications are good for preventing ACS?

A

5 As

  • Aspirin 75mg OD
  • Anti-platelet (Clopidogrel for 12 months)
  • Atorvastatin
  • ACEi
  • Atenolol
29
Q

Why are anti-platelets the mainstay of treatment in ACS?

A

The plaques that cause ACS are mostly made up of platelets.

30
Q

What is the treatment for STEMI?

A
  • Notify cardiac centre immediately
  • Primary PCI vs thrombolysis
  • Follow their advise re. anti-platelets etc. in the meantime
31
Q

What is the treatment for NSTEMI?

A 
BATMAN
Beta-blocker
Aspirin 300mg
Ticagrelor 180mg/Clopidogrel 300mg
Morphine
Anticoag (LMWH Tx dose)
Nitrate
32
Q

What are the complications of an ACS?

A

DREAD

  • Death
  • Rupture of heart septum/papillaries
  • Edema/HF
  • Arrythmia
  • Dressler’s Syndrome
33
Q

What is Dressler’s Syndrome?

A

Post-MI pericarditis occurring 2-3 weeks after

34
Q

How does Dressler’s Syndrome present?

A
  • Pleuritic chest pain
  • Low grade fever
  • Pericardial rub
35
Q

What does and ECG show in Dressler’s Syndrome?

A
  • Global Saddle ST elevation

- T inversion

36
Q

How is Dressler’s treated?

A
  • NSAIDs

- Steroids only if patient very unwell

37
Q

What can Dressler’s cause, and how is this treated?

A
  • Pericardial tamponade

- Pericardiocentesis

Junior Medicine- Cardiology (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions