ACS - acute coronary syndrome Flashcards
What is ACS
A spectrum of conditions which include MI with or without ST segment elevation
How are unstable angina and NSTEMI caused
Partial blockage of a blood vessel
Where is myocardial necrosis more evident, NSTEMI or STEMI
STEMI
What is STEMI
Complete blockage of blood vessel = causes irreversible necrosis of heart muscle. It is the worse form of ACS
What levels can we measure to detect heart attack
Troponin levels
Symptoms of ACS
Chest pain
Can spread to left arm
Can be triggered by physical exertion or stress
Stops within a few mins of resting
What is stable angina
Predictable, symptoms occur on activity, stop when resting
What is unstable angina
Unpredictable, chest pain is still there on resting and is for longer and more severe
What is the initial management of ACS
Why is GTN, iv opioids e.g. morphine given ASAP in initial management of ACS?
Pain relief
Why is Aspirin given in initial management of ACS?
To limit clot size and allow blood to flow
Why is oxygen given in initial management of ACS?
Only if needed
In what instance would insulin be given in initial management of ACS
If glucose is higher than 11mmol/l
What is the secondary prevention of ACS
Why are nitrates useful in angina
They are coronary vasodilators
What are the three common forms of GTN
Patches, tablets, sprays
What are some side effects of nitrates
Flushing, headaches and postural hypotension
How long does GTN last for
20-30 mins
How is the GTN spray used
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
When do you need long term prophylaxis
When GTN is being used more than twice a week
What strength GTN tablets are used
300 mcg
How should tablets be supplied
In glass containers (no more than 100 tablets) in foil line caps
How many weeks after should they be discarded
8 weeks
How often should GTN patches be changed
Every 24 hours
