ACS Flashcards
Right coronary artery supplies the
Right atrium and ventricle
Inferior left ventricle
Posterior septal area
Left coronary artery divides into
Circumflex artery
left anterior descending artery
Circumflex artery supplies
left atrium
posterior left ventricle
Left anterior descending supplies the
anterior left ventricle
anterior septum
ECG changes in a STEMI
ST segment elevation
New left bundle branch block
ECG changes in an NSTEMI
ST segment depression
T wave inversion
Pathological Q waves suggest
deep infarction involving the full thickness of the heart
Q waves typically appear
6 or more hours after the onset of symptoms
Left coronary artery infarction will show on ECG leads
I, aVL, V3-V6
Left anterior descending infarction will show on ECG leads
V1-V4
Circumflex artery infarction will show on ECG leads
I, aVL, V5-6
Right coronary artery infarction will show on ECG leads
II, III and aVF
PCI should be performed in STEMI patients
within 2 hours of presenting
Alternative causes for a raised troponin other than an MI
CKD, sepsis, myocarditis, aortic dissection, PE
If PCI cannot be performed within 2 hours thrombolytics such as … should be used
streptokinase, alteplase, tenecteplase
mnemonic for the management of an NSTEMI
BATMAN
management of an NSTEMI
Base the decision about angiography based of a GRACE score
Aspirin 300mg
Ticagrelor
Morphine
Antithrombin (fondaparinux)
Nitrate
What does a GRACE score calculate
6 month probability of death after an NSTEMI
A GRACE score above… suggests medium to high risk and means patients should be considered for early angiography
3%
Complications of MI
Death
Rupture of the heart septum or papillary muscles
oedema
Arrhythmia
Aneurysm
Dressler’s syndrome
Dressler’s syndrome usually occurs
2-3 weeks after an MI
What is Dressler’s syndrome
localised immune response causing pericarditis
Prolonged ST elevation after MI is indicative of
Left ventricular aneurysm
