ACS & AMI - Therapy Flashcards
What does ACS stand for?
Acute coronary syndrome
What does AMI stand for?
Acute myocardial infarction
What is in the spectrum of acute coronary syndrome?
1) Unstable angina
2) Non-ST elevated myocardial infarction (NSTEMI)
3) ST elevated myocardial infarction (STEMI)
4) Sudden cardiac death
What does NSTEMI stand for?
Non-ST elevated myocardial infarction
What does STEMI stand for?
ST elevated myocardial infarction
What are some causes of acute coronary syndrome?
Atherosclerosis plaque rupture or erosion
Superimposed platelet aggregation and thrombosis
Vasospasm and vasocontriction
Subtotal or transient total occlusion of vessel
What is the goal of pharmacotherapy for acute coronary syndrome?
Increase myocardial oxygen supply
Decrease myocardial oxygen demand
How can myocardial oxygen supply be increased?
Vasodilation
How can myocardial oxygen demand be decreased?
Decrease heart rate
Decrease blood pressure
Decrease preload or myocardial contractility
What has a high likelihood of being the cause of patients with STEMI?
Coronary thrombus occluding the infarct artery
What is coronary thrombus formation usually due to?
Formation of thrombus overlying an atheromatous plaque occluding the coronary artery
What is the treatment for coronary thrombus formation?
If no percutaenous coronary intervention (PCI) within 2 hours then thrombolysis is indicated
What does PCI stand for?
Percutanous coronary intervention
What is percutaneous coronary intervention?
Non-surgical procedure that uses a catherter to place a stent to open up blood vessels in the heart that have been narrowed
What is a stent?
Thin flexible tube
What is a non-surgical procedure that uses a catheter to place a stant to open up blood vessels in the heart that have been narrowed?
Percutaneous coronary intervention
What agents are used for thrombolysis?
Serine proteases
How do serine proteases work?
Converting plasminogen to the fibrinolytic agent plasmin