ACS and AMI Flashcards

1
Q

What three acute coronary syndromes can thrombosis in a coronary artery lead to?

A
  • Unstable angina - NSTEMI - STEMI
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2
Q

When will symptoms of ACS show?

A
  • At rest - Stable angina will only present on exertion
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3
Q

What is the SOCRATES history of a person with ACS?

A
  • Retrosternal chest pain - Tight band - Radiation to neck/jaw and down arms - Aggravating with exertion, emotional stress - NOT FULLY RELIEVED WITH GTN
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4
Q

What are the non modifiable risks for coronary artery disease?

A
  • Age - Gender - Creed - Family history - Previous angina - Cardiac events
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5
Q

What are the modifiable risks for coronary artery disease?

A
  • Smoking - Diabetes mellitus - Hyperlipidaemia - Hypertension - Lifestyle (exercise and diet)
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6
Q

How do you make the diagnosis of unstable angina (UAP)?

A
  • Angina on effort - Progressive increasing frequency and severity - Often at rest
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7
Q

How do you make the diagnosis of NSTEMI?

A
  • Patient presents with myocardial ischaemic symptoms at rest - ECG will show unelevated ST segment but troponin levels will be high
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8
Q

What will a patient with UAP or NSTEMI show on examination?

A
  • No specific features to find - Check HR, BP - Listen for murmurs and crackles
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9
Q

What will be seen on an ECG of patients with UAP and NSTEMI?

A
  • ST segment depression - ST transient elevation - T wave inversion
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10
Q

Using an ECG how do you differentiate between NSTEMI and UAP?

A
  • UAP ECG changes usually resolve after pain subsides - NSTEMI doesn’t
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11
Q

NSTEMI and UA ECG with ST segment depression

A
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12
Q

NSTEMI and UA ECG with T wave reversal

A
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13
Q

What are the possible symptoms of atypical ACS?

A
  • Breathlessness alone (w/ wo/ signs of heart failure)
  • Nausea and vomiting
  • Epigastric pain (recent indigestion)
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14
Q

What biomarkers are raised after a NSTEMI and UA?

A
  • Cardiac troponin (cTn)
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15
Q

What other condition can raise cTn?

A

Atherothrombosis

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16
Q

What immediate treatment is needed for NSTEMI and UA?

A
  • DR ABCDE
  • MONA
17
Q

What does MONA stand for?

A
  • Morphine
  • Oxygen
  • Nitrglycerine (GTN)
  • Aspirin
18
Q

Along with aspirin, what other antiplatelet measure should be given for ACS?

A
  • Clopidogrel
  • Prasurgrel
  • Ticagrelor
19
Q

What antithrombotic therapy is available for ACS?

A
  • Low molecular weight heparin (LMWH)
  • Fondaparinux (better than heparin)
20
Q

What other therapies are recomended following ACS?

A
  • B blockers
  • Statins
  • ACEI
21
Q

When would coronary revascularisation be used?

A
  • High risk patients
  • Benefits outweigh risks
22
Q

What causes an ST elevation MI?

A
  • Plaque rupture leading to a more complete or totally complete occlusion of coronary lumen
  • Infarction of distal myocardium
23
Q
A