ACS and AMI -Presentation and Investigation

Question 1

what is an acute coronary syndrome

Answer 1

Any sudden cardiac event suspected or proven to be related to a problem with the coronary arteries

Question 2

when diagnosing a suspected MI what evidence are you looking for

Answer 2

detection of cardiac cell death e.g raised troponin levels

and one of:

• symptoms of ischemia
• ECG changes
• evidence of coronary problem

Question 3

what are the cardiac risk factors for ACS

Answer 3

male more likely
increasing age
known heart disease
high cholesterol
diabetes
smoker
family history

Question 4

what are contraindications of thrombolysis

Answer 4

• bleeding
• don’t give if recent stroke or intracranial bleed
• caution if recent surgery
• caution if on warfarin

Question 5

what is the general management of suspected acute coronary syndrome

Answer 5

admit to hospital
cardiac monitor
give O2 if levels low

Question 6

what investigations would be done for suspected acute coronary syndrome

Answer 6

ECG's
Blood tests
-anaemic?
-kidney function?
-cholesterol/thyroid?

Question 7

if a patient has been admitted for a suspected ACS and is experiencing further chest pain what medication can be given

Answer 7

glycerol trinitrate

this is a vasodilator which opens up the coronary arteries

Question 8

what are risks of carrying out PCI on a patient

Answer 8

bleeding
blood vessel damage
MI
stroke
dye can affect kidneys

Question 9

what can be complications following an MI

Answer 9

arrhythmia
papillary muscle rupture
cardiogenic shock
mechanical problems