ACS Flashcards
What is the pathophysiology of ACS?
Artheromstous plaque formation in coronary vasculature, exposing fibrin, collagen, cholesterol and cellular debris
This creates stimulation for: platelet adhesion, aggregation, thrombus formation and localised vasoconstriction
ACS is a …
Critical stage of IHD with differing degrees of occlusion and embolisation
What is the pathophysiology for a stable angina?
Stable intact lesion
What is the pathophysiology of unstable angina?
Breached endothelium with or without superimposed fibrin clot and coronary spasm
What is the pathophysiology of an MI?
Plaque rupture with superimposed fibrin clot leading to total coronary occlusion and coronary spasm
How do you diagnose ACS?
Pt history
Typical symptoms
ECG changes
Biochemical markers
What is the rational for the assessment of ACS?
Diagnostic Therapeutic Humanistic concern Improve and maintain pt nurse relationship Accountability
What are the possible differential diagnosis for a of presenting with ACS?
Angina pectoris MI Pericarditis Dissecting aortic aneurysm Tracheobronchitis Pleural pain Reflux oesphagitis Chest wall pain Anxiety
What is the PQRST assessment of chest pain?
Precipitating factors Qualitative factors Region and radiation Severity and associated symptoms Timing
What is included in precipitating factors for Chest pain assessment?
What factors precipitated discomfort?
What was happening at symptom onset?
What is included in qualitative factors in chest pain assessment?
Describe pain
What does pain feel like in own words
How did or feel at time of pain?
What is included in region and radiation for chest pain assessment?
Where and how far pain spreads
Pain normally in left arm, inner aspect of arm sometimes as far as fingers, jaw (not to ear), neck, back, epigastrium
What is included in severity and associated symptoms for chest pain assessment?
How bad is the pain?
0-10
Aware of any other pain?
What is included in timing for the chest pain assessment?
How long did it last?
What makes the pain better?
What are the or groups with atypical presentations of ACS?
Women
Elderly
Diabetes
Ethnic minority