Cardiac Flashcards
ACS is an umbrella term for 3 things….
Unstable Angina, STEMI and NSTEMI
Main component of STEMI and NSTEMI thrombus
STEMI = Fibrin Rich NSTEMI = Platelet rich
Difference between NSTEMI and STEMI in tissue damage
STEMI = Artery occlusion leading to myocardial infarction NSTEMI = Transmural myocardial ischaemia
Difference between NSTEMI and Unstable angina
Unstable angina does not cause a rise in troponin
4 characteristics of ACS chest pain
- Heavy, aching or tight
- Central or left sided
- Not related to respiration
- May radiate to arm, neck or jaw
Who is most likely to have a silent MI and what are the symptoms
Women and the elderly
Syncope, vomiting and epigastric pain
What does ST elevation on an ECG indicate?
Infarction (irreversible damage)
What does ST depression on an ECG indicate?
Ischaemia (reversible damage
Which is the most sensitive cardiac enzyme test and when does it rise/peak
Troponin
Rise in 3-12 hours and peak within 24-48
Which type of Creatining kinase is found in the heart and when does it rise/peak
ck-mb (ck-mm in skeletal muscle)
Rises in 3-12 hours and peak within 24
Is Myoglobin specific or sensitive?
Highly sensitive (Positive results gives high chance of MI)
Immediate medical treatment of MI including dose (Mnemonic)
MONAC Morphine - 5-10mg IV Oxygen - 100% NRBM Nitrate - (GTN) Aspirin - 300mg PO Clopidogrel - 300-600mg PO loading dose and 75mg OD
When is thrombolysis considered?
In patients with ST elevation who present within 12 hours of onset of symptoms.
Should be done as soon as possible but must be within 120 mins of when fibrinolysis could have been given
Pathogenesis of stable angina
LDL cholesterol builds up in the coronary arteries producing atherosclerotic plaques
2 criteria for stable angina
- Precipitated by exercise
2. Relieved by rest/GTN within 5 mins
