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5th yr- DENTAIM > Acute cardiac Ischaemia > Flashcards

Acute cardiac Ischaemia Flashcards

1
Q

What are the 2 common pathologies that cause acute cardiac ischaemia

A
  1. Stable angina

2. Acute coronary syndrome (ACS)

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2
Q

What is acute cardiac ischaemia

A

A term used to describe reduced oxygen delivery to the heart

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3
Q

What is stable angina

A

A chronic condition caused by the narrowing of the coronary arteries restricting blood flow

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4
Q

What is acute coronary syndrome

A

An umbrella term used to describe unstable angina and myocardial infarction

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5
Q

What is acute coronary syndrome associated with

A

Severe interruption of blood flow to the heart

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6
Q

What fall under Acute coronary syndrome

A
  1. Unstable angina
  2. Non ST elevation myocardial infarction
  3. ST elevation myocardial infarction
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7
Q

What does unstable angina suggest

A

Suggest a deterioration of the chronic condition without damage to the heart muscles

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8
Q

What is the main difference between Non ST elevation myocardial infarction and ST elevation myocardial infarction

A

ST elevation myocardial infarction can be visible on the ST segment on the ECG due to significant damage to heart muscle

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9
Q

What is present in blood vessels in a patietn with stable angina

A

Atheroma plaque

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10
Q

What does atheroma plaque in blood vessels do

A

It reduces the lumen size

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11
Q

What does a reduced lumen size impact

A

Impacts blood flow and oxygen delivery

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12
Q

When are the symptoms of ischaemia present in a patietn with stable angine

A

When there’s increased Demand for blood and oxygen but the lumen size is insufficient

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13
Q

What is present in blood vessels in a patient with acute coronary syndrome

A

Larger atheroma plaques are present

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14
Q

What does large atheroma plaque in blood vessels lead to

A

Reduced blood flow leading to further symptoms of ischaemia experienced even without trigger

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15
Q

What does narrowing of the lumen size lead to

A

Increased blood pressure

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16
Q

What can prolonged increased blood pressure cause

A

May result in erosion of the atheroma plaque

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17
Q

What can erosion of the atheroma plaque cause

A

Can cause bleeding and a blood clot to form at the rupture site

18
Q

If a patient is experiencing chest pain for the first time what should they do

A

Call 999 and treat of acute coronary syndrome

19
Q

List the risk factors for cardiac ischaemia

A
  1. Diabetes
  2. hypertension
  3. Obesity
  4. Smoking
20
Q

Describe the typical presentation of acute cardiac ischaemia

A
  1. Chest pain
  2. Radiation of pain to arm, back, jaw
  3. Shortness of breath
  4. Nausea
21
Q

What acronym do we use to identify acute cardiac ischaemia

A

THE DRS

22
Q

What does THE DRS stand for

A 
Trigger
History 
Episodes
Duration 
Resolution 
Severity
23
Q

What os the trigger for stable angina

A

Obvious exertion or emotional trigger

24
Q

What is the typical history for stable angina

A

Known angina in patient

25
Q

How long does a stable angina episode last

A

Symptoms usual resolve in less than 15 minutes

26
Q

How does stable angina resolve

A

May resolve with rest or fast response to nitrates (GTN)

27
Q

How might a patient describe the severity of stable angina

A

Pain typical of patients with normal angina

28
Q

What is the trigger for acute coronary syndrome

A

Unclear trigger

29
Q

What is the history of acute coronary syndrome

A

No previous chest pain

30
Q

How long does an acute coronary syndrome episode last

A

Symptoms continue in excess fo 15 minutes

31
Q

How does acute coronary syndrome resolve

A

Slow or minimal response to nitrates

32
Q

How might a patient describe the severity of acute coronary syndrome

A

Severity worse than typical angina pain

33
Q

Talk through the THE DRS for stable angina

A

T- Obvious
H- Known Angina
E- No increased frequency of episodes
D- Symptoms resolve in less than 15 minutes
R- May resolve with rest or fast response to nitrates
S- Pain typical of patients normal angina

34
Q

Talk through the THE DRS for acute coronary syndrome

A

T- Unclear trigger
H- No previous chest pain
E- increased frequency of episodes
D- Symptoms continue in excess of 15 minutes
R- Slow or minimal response to nitrates
S- Severity worse than typical angina pain

35
Q

How do we manage stable angina

A
  1. Rest
  2. Glyceryl Trinitrate (GTN)
  3. Monitor
36
Q

How does GTN work

A

Dilates blood vessels improving oxygen delivery

37
Q

What is the maximum number of doses of GTN

A

6 max

38
Q

How do we monitor stable angina

A

Using the ABCDE approach

39
Q

How do we manage acute coronary syndrome

A
  1. Glyceryl Trinitrate (GTN)
  2. Aspirin
  3. Oxygen
  4. Monitor
40
Q

What does aspirin do in an acute coronary syndrome patietn

A

Inhibits clot formation reducing damage to the heart muscle

41
Q

when do we give a patietn with acute coronary syndrome oxygen

A

When hypoxia is identified

42
Q

What is hypoxia indicated with

A

Oxygen saturation of less than 94%

5th yr- DENTAIM (8 decks)

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