Acute Ischemic Heart Disease - Yaacoub Flashcards
(40 cards)
ASA contraindicated in
severe aspirin allergy
Implement desensitization
NonSTEMI can also be associated with
normal ECG
Preferred clopidogrel strategy
Pretreatment
29% reduction in death/MI in PCI patients
Clopidogrel Tx
RV infarction
HoTN
JVD
Clear lungs
Most important criteria in TIMI risk score
Age >65
>3 risk factors for CAD
ST changes
Prior coronary stenosis
> 2 anginal episodes in the past day
Elevated cardiac markers
Use of ASA within 7 days
RRR (relative risk reduction) of ____ with early invasive intervention
49%
In first 24 hours, __ STEMI patients and __ NSTEMI patients
26%
14%
4 Highest reductions in mortality
- Heparin, ASA
- BB
- Cath
Nitrates contraindicated in patients with
RV infarction
PDE inhibitors
Relative risk of death in ST changes
T wave inv = 62%
STE= 68%
STD = 2.27
**ST depression is the worst prognostic marker
___ has higher bleeding complications and lower combined endpoints of death/MI/revascularization
Prasugrel
Low risk ACS
New-onset or progressive CCS class 3 or 4
Normal or unchanged ECG during chest discomfort
Normal cardiac markers
Avoid BB with
intrinsic sympatholytic activity
Global diffuse ST changes without reciprocation
pericarditis
Which risk is higher, No troponin and CAD, or +troponin and no CAD
No troponin and CAD
May use __ as substitute for ASA
clopidogrel
abciximab + heparin is most beneficial for patients with
troponin elevation
(vs. just heparin)
Score 6/7 is the greatest risk, at ___%
41%
Use 2b3a in whom
those who are at higher risk
benefit most profound with stented diabetics
Intermed risk patients for ACS
Prior MI, PVD, or CABG
Prolonged rest angina now resolved
Rest angina under 20 min
Age above 70
T wave inversions >.2mV
Pathological Q waves
Slightly elevated cardiac markers
Risk stratification based on
TIMI risk score
Everyone with Stent and most with PCI get
DAPT
Acute anterior wall MI is what vessel
LAD
