5 Cardiology - ACS Flashcards
Initial symptoms of ACS
Chest pain
Raised cardiac markers
ECG chanfes
There is a large variation in patient capacity to activate which antiplatelet
clopidgrel
ACS is caused by….?
disruption or rupture of an arthersclerotic plaque
UA and NSTEMI result from…
STEMI results from…
partially occlusive thrombus
STEMI is from an occlusive thrombus
2 cardiac markers
Troponin (TnT and Tnl)
Creatanine kinase - may also rise from exercise!
What is PCI?
percutaneous coronary intervention - opening up vessels using balloons and stents
Does t-PA help in MI?
reduced mortality in STEMI not NSTEMI.
Superseded by PCI
What are glycoprotein 2B/3A inhibitors
antiplatelets used in NSTEMI and UA in pt with high risk factors
e.g. abciximab, tirofiban
What are glycoprotein 2B/3A inhibitors
antiplatelets used in NSTEMI and UA in pt with high risk factors
e.g. abciximab, tirofiban
After MI patients should be offered (2)
cardiac rehabillitation
advice on modifiable risk
4 drugs everyone gets post MI
Antiplatelet
Statin
ACEi
Beta
Depending on diagnosis:
- Clopidogrel/ticagrelor/prasugrel
- Aldosterone antagonsits
What antiplatelets are given post MI
-Aspirin 75mg lifelong
-Second antiplatelet for 12 months after NSTEMI or PCI
Clopidogrel, ticagralo and prasagrel (STEMI only)
Advantage/disadvantage of prasugrel/ticagralor over clopidogrel?
Clop - less bleed risk but less predictable effect
What statin to offer post MI
Atrovastatin 80mg
How do Beta blockers help?
- Reduce myocardial contractility and oxygen demand
- Reduces blood pressure spikes in stress
- Reduces risk of arrhythmia
