ACS - unstable angina, STEMI and NSTEMI Flashcards
what is unstable angina?
acceleration in severity or frequency of chest pain
new onset angina pain that doesn’t relieve with rest
what is an NSTEMI?
unstable plaque rupture and thrombosis - partial occlusion
what would be seen on ECG for NSTEMI?
ST depression
inverted T wave
what is a STEMI?
complete occlusion of artery
what would be seen on ECG in STEMI?
ST elevation
clinical features of acute MI?
pain - specific left radiating
nausea and vomiting
dizziness, syncope
sweating/ SOB
ECG and enzymatic changes
what are cardiac troponin T and I?
biomarkers of cardiac muscle damage and death
what is troponin t?
less specific
released from both cardiac and skeletal muscle
what is troponin I?
specific ideal marker only in myocardial injury
diagnostic criteria of MI?
rise/fall of biomarkers AND at least one of:
- symptoms
- ECG changes
- development of Q waves
- loss of myocardium
2 clinical management aims?
myocardial salvage
improve survival/ secondary prevention
how to implement myocardial salvage?
1 - reduce myocardial oxygen demand
2 - restore blood supply through reperfusion
drugs to reduce oxygen demand?
beta blockers
nitrates
drugs to restore blood supply?
thrombolytic ‘clot busters’
anticoagulant and antiplatelet combo
PCA/stent
lifestyle changes post-MI?
diet change
lower alcohol consumption
smoking cessation
weight management
