16 Investigating Acute Coronary Syndrome Flashcards
What is a Type 1 MI?
MI due to: Atherosclerotic plaque rupture, ulceration, fissure etc leading to thrombus in 1+ coronary arteries causing myocardial necrosis
What is a Type 2 MI?
Condition causing imbalance between myocardial oxygen supply and demand e.g.: -Coronary artery spasm -Hypotension -Anaemia
What is a Type 3 MI?
Sudden cardiac death when biomarkers=unavailable e.g. during the lag period before serum markers appear in the blood
What is a Type 4 MI?
Percutaneous coronary intervention (stent)
What is a Type 5 MI?
Coronary Artery Bypass
What may have happened to cause ACS?
Coronary occlusion/narrowing Due to: plaque rupture/dissection/other risk factors
If there are changes in the inferior leads on the ECG, where is the occlusion going to be?
Right coronary artery
If there are changes in the anterior leads on the ECG, where is the occlusion going to be?
LAD
If there are changes in the lateral leads on the ECG, where is the occlusion going to be?
diagonal, obtuse marginal, circumflex
What does an invasive angiogram allow for?
Identification of stenosis/occlusion/dissection in specific vessels
What might a chest x-ray show?
Pulmonary Oedema
Where should ECG leads be placed?
V1- right of sternal border- 4th intercostal space
V2- left of sternal border- 4th intercostal space
V3- halfway between V2 and V4
V4- midclavicular line- 5th intercostal
V5- left anterior axillary line- in horizontal plane of V4
V6- midaxillary line- in horizontal plane of V4
How long after cardiac damage might troponin levels be raised?
3 hrs- peak at 24-48 hrs- remains elevated 2+ weeks
What does an echocardiogram do?
Evaluates structure and function i.e. chambers, valves, flow patterns
How is an invasive coronary angiogram carried out?
Local anaestetic, radial/femoral artery access
