ACS

Question 1

Risk factors for MI:

Answer 1

Previous hx of ischaemic heart disease and peripheral vascular disease, smoking, alcohol, obesity, family hx, diabetes, CKD, age+, high cholesterol.

Question 2

Symptoms that are high risk for MI:

Answer 2

Pain >20minutes, worsening angina, hypotension, pulmonary oedema, arrhythmias.

Question 3

ACS Management:

Answer 3

DRABCDE
ECG within first 10 minutes - repeat every ten minutes if STEMI not present on ECG but patient has clinical features.
Aspirin (Unless contraindicated)
GTN (Unless hypotensive/contraindicated)
Morphine is analgesia of choice in MI.
Extrication - nil self extrication
Monitoring remains on
Prealert

Question 4

Physical symptoms of MI:

Answer 4

Central, heavy, crushing chest pain radiating into the back, shoulder, arm, neck, jaw.
A feeling of somebody sitting on the chest.
Feeling of impending doom.
Grey tone, pallor, clammy cool skin, sweaty.
N&V.
Breathlessness.
Initially tachycardic & hypertensive.

Question 5

Reassessment during transport of ACS:

Answer 5

Continuous cardiac monitoring.
IV if able,indicated, time allows.
Do not delay on scene.

Repeat GTN if discomfort persists.
Repeat ECG.

Question 6

Risk of ___ is high in early stages of ACS.

Answer 6

VF

Question 7

If ST elevation is present in the INFERIOR views perform a ___

Answer 7

Right sided ECG

Question 8

If ST depression is present in V1 to V3 (Septal-anterior) perform a ___

Answer 8

Posterior ECG

Question 9

ST elevation criteria is:

Answer 9

MALES - 2mm or more ST elevation in 2 adjacent ANTERIOR leads (V2&V3)
FEMALES - 1.5mm for the same
OR
1mm or more ST elevation in 2 adjacent leads of the same view
OR
LBBB/Paced and CCP and looks like they’re having an MI.

Question 10

Posterior (the rarest) STEMI:

Answer 10

0.5mm or more ST ELEVATION in V7 & V8
Convey as posterior STEMI to Cath Lab.