acute coronary syndrome

Question 1

what is usual cause

Answer 1

usually result of thrombus from a atherosclerotic plaque blocking coronary artery

Question 2

what does right coronary artery supply

Answer 2

right atrium
rigt ventricle
inf L venticle
posterior septal area

Question 3

what does L coronary artery split into

Answer 3

circumflex a

left anterior descedning a

Question 4

what does circumflex ca supply

Answer 4

’’’
left atrium
posterior L ventricle

Question 5

what des left anterior desc artery supply

Answer 5

ant L ventricle

anterior septal area

Question 6

symptoms of ACS

Answer 6

central chest pain 
N&V
sweating, clamminess
SOB
palpitation 
pain jaw, arm

Question 7

STEMI ECG features

Answer 7

ST elevation

new left bundle branch block

Question 8

NSTEMI ECG features

Answer 8

ST depression
T wave inversion
pathological Q waves

Question 9

L coronary artery occlusion

Answer 9

anterolateral

I, aVL, V3-V6

Question 10

left anterior descending occlusion

Answer 10

anterior

V1-V4

Question 11

circumflex occlusion

Answer 11

lateral

I, aVL, V5, V6

Question 12

right coronary artery occlusoin

Answer 12

inferior

II, III, aVL

Question 13

alternative causes raised troponin

Answer 13

chronic renal failure 
sepsis 
PE
aortic dissection
myocarditis

Question 14

investtigations

Answer 14

ECG
troponin 
FBC
U&Es
LFTs
lipids, HbA1c, thyroid 
ECHO 
CXR
CTCA

Question 15

acute STEMI treatment

Answer 15

primary PCI if available within 2hr presentation

thrombolysis if outwith 2hrs

Question 16

acute NSTEMI treatment

Answer 16

beta blocker
aspirin 
DOACs
morphine 
anticoagulant 
GTN

Question 17

GRACE score

Answer 17

assess for PCI in NSTEMI

6mo risk death or repeat MI after NSTEMI

Question 18

MI complications

Answer 18

death,
septum/papillary muscle rupture,
arrythmia,
dressler’s syndrome,

Question 19

dressler’s syndrome

Answer 19

2-3wks after MI

localised immune response causes pericarditis

Question 20

dressler’s syndrome clinical

Answer 20

pleuritic chest pain
fever
pericardial rub

Question 21

dressler’s syndrome diagnosis

Answer 21

ECG - ST elevation, T wave inversion
ECHO
inc CRP

Question 22

dressler’s syndrome management

Answer 22

NSAIDs

steroids

Question 23

2ry prevention

Answer 23

dual anticoagulant - aspirin, ticagrelol
statin
ACEI
beta blocker

Question 24

2ry prevention lifestyle

Answer 24

stop smoking
less alcohol
diet
cardiac rehab

Question 25

type 1 MI

Answer 25

‘traditional’

due to coronary event

Question 26

type 2 MI

Answer 26

ischaemia due to inc demand or drop supply O2

severe anemia, hypotension etc

Question 27

type 3 MI

Answer 27

sudden cardiac death

Question 28

type 4 MI

Answer 28

assoc w PCI/stenting/CABG