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Cardiovascular > ACS - acute coronary syndrome > Flashcards

ACS - acute coronary syndrome Flashcards

1
Q

What is ACS

A

A spectrum of conditions which include MI with or without ST segment elevation

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2
Q

How are unstable angina and NSTEMI caused

A

Partial blockage of a blood vessel

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3
Q

Where is myocardial necrosis more evident, NSTEMI or STEMI

A

STEMI

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4
Q

What is STEMI

A

Complete blockage of blood vessel = causes irreversible necrosis of heart muscle. It is the worse form of ACS

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5
Q

What levels can we measure to detect heart attack

A

Troponin levels

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6
Q

Symptoms of ACS

A

Chest pain

Can spread to left arm

Can be triggered by physical exertion or stress

Stops within a few mins of resting

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7
Q

What is stable angina

A

Predictable, symptoms occur on activity, stop when resting

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8
Q

What is unstable angina

A

Unpredictable, chest pain is still there on resting and is for longer and more severe

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9
Q

What is the initial management of ACS

A
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10
Q

Why is GTN, iv opioids e.g. morphine given ASAP in initial management of ACS?

A

Pain relief

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11
Q

Why is Aspirin given in initial management of ACS?

A

To limit clot size and allow blood to flow

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12
Q

Why is oxygen given in initial management of ACS?

A

Only if needed

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13
Q

In what instance would insulin be given in initial management of ACS

A

If glucose is higher than 11mmol/l

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14
Q

What is the secondary prevention of ACS

A
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15
Q

Why are nitrates useful in angina

A

They are coronary vasodilators

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16
Q

What are the three common forms of GTN

A

Patches, tablets, sprays

17
Q

What are some side effects of nitrates

A

Flushing, headaches and postural hypotension

18
Q

How long does GTN last for

A

20-30 mins

19
Q

How is the GTN spray used

A

1 tablet (or 1-2 sprays) and wait 5 mins. Then do the second dose and wait 5 mins

Seek medical attention if still hasn’t worked

20
Q

When do you need long term prophylaxis

A

When GTN is being used more than twice a week

21
Q

What strength GTN tablets are used

A

300 mcg

22
Q

How should tablets be supplied

A

In glass containers (no more than 100 tablets) in foil line caps

23
Q

How many weeks after should they be discarded

A

8 weeks

24
Q

How often should GTN patches be changed

A

Every 24 hours

25
Q

How soon after opening should rectal ointments be discarded?

A

8 weeks

26
Q

How is isosorbide dinitrate active

A

Sublingually

27
Q

How often is Dinitrate given

How often is mononitrate given

A

BD and OD

28
Q

What can you do to prevent tolerance with isosorbide?

A

Take MR isosorbide once daily tablets

For BD tablets take second dose after 6-8 hours, not 12

For patches, leave off overnight ( 8-12 hours) in each 24 hours

29
Q

Long term treatment of stable angina

A

Cardiovascular (8 decks)

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