MI Cases- Leah (3) Flashcards Preview

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Flashcards in MI Cases- Leah (3) Deck (8)
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1

Initial management of chest pain in the ER?
Drugs + what should you DO?

MONA

Morphine
Oxygen
Nitroglycerin; (unless HYPOtensive patient/inferior wall infarct)
Aspirin

+ EKG, troponins, Call cath lab

2

When are thrombolytics the standard of care for acute MI?

-Only when you cannot get the patient into a cath lab within two hours
-Otherwise, cath/angioplasty are the standard of care

3

What are long term treatments for MI?

SAAB
(^^^*Winning* - this makes me so happy :) )

-Statins (prevent plaques, prevent inflammation)
-Anti-coagulants (if patient got stent)
-ACEi (prevents ventricular remodeling)
-B-blockers

4

Acute coronary syndrome criteria

Must meet 2/3:

-Chest discomfort
-+ troponins
-EKG changes

5

TMI Risk score for NSTEMI

THREATS

T-timing in last 24 hours
H- history of CAD known
R- risk factors for CAD (3 or more)
E- EKG change
A-aspirin use in last 24 hours
T- troponins elevated
S-sixty five or older

Each risk = one point

6

Difference between unstable angina and MI:

Just troponins (bc cell death)
-unstable angina will have normal troponins, MI will not

7

What is broken heart syndrome?

Stress cardiomyopathy; diffuse vasospasm
Thought to be brought on by hormone surge
Does not increase risk of MI
**Do spill troponins and see EKG changes
Treat like MI until proven otherwise.

8

What are "reciprocal" changes on EKG in a STEMI?

-ST depression in leads V1-3, if elevation is in leads 1-3, or vice versa.
(Location of elevation/depression depends on location of infarct)

Solidifies diagnosis