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PHA222 > ACS > Flashcards

ACS Flashcards

1
Q

What is ACS?

A

A spectrum of acute myocardial ischaemia

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2
Q

Describe how ACS occurs

A

Acute plaque rupture in the epicardial coronary artery wall, leading to an abrupt decrease/stoppage of blood flow to the heart

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3
Q

List the 3 clinical subtypes of ACS

A

UA
STEMI
NSTEMI

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4
Q

State how UA & NSTEMI are similar

A

clinical presentation

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5
Q

State how UA & NSTEMI differ

A

duration & severity

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6
Q

Describe 3 characteristics of UA on chest/anginal pain

A
  • new onset
  • abrupt pain at rest
  • acceleration of freq/severity
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7
Q

Describe the cause of UA

A

Unstable plaque rupture and thrombosis leads to incomplete/transient occlusion of coronary artery

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8
Q

In patients with UA what risk is increased due to the presence of active prothrombotic surface at site of plaque rupture

A

increased risk of MI

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9
Q

Describe the cause of NSTEMI

A

Unstable plaque rupture and thrombosis leads to significant partial/intermittent occlusion of coronary artery

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10
Q

Is there evidence of myocardial cell necrosis for patients with NSTEMI

A

yes - positive evidence

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11
Q

In patients with NSTEMI what risk is increased due to the presence of active prothrombotic surface at site of plaque rupture

A

ischaemia

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12
Q

Describe the cause of STEMI

A

Unstable plaque rupture & thrombosis leading to complete occlusion of the artery

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13
Q

In STEMI occlusion of the artery leads to…

A

sustained myocardial ischaemia

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14
Q

How is the risk of sudden cardiac death increased in STEMI patients

A

Ischaemia induced electrical instability leads to abnormal cardiac rhythm

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15
Q

List 2 temporal characteristics of ACS

A

Cell necrosis within 20-40mins of occlusion

Significant cell necrosis @ 2-3hrs

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16
Q

Name the 2 phases that determine reversible/irreversible myocardial injury

A

Ischaemia - reversible

Infarction - irreversible

17
Q

Describe the clinical features of ACS

A
  • chest pain that doesnt go away
  • pain radiates to arms/neck/jaw
  • breathlessness, dizziness, syncope, hypotension
  • ECG changes; ST-segment elevation/depression, T wave inversion, pathological Q wave development
  • cardiac biomarker changes; serum levels of myoglobin, troponin, CK-MB, biomarkers of MI
18
Q

Describe the pathology behind dizziness, syncope, breathlessness & hypotension of ACS

A

Due to acute LV failure & abnormal cardiac rhythm

PHA222 (7 decks)

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