acute coronary syndrome Flashcards
what is usual cause
usually result of thrombus from a atherosclerotic plaque blocking coronary artery
what does right coronary artery supply
right atrium
rigt ventricle
inf L venticle
posterior septal area
what does L coronary artery split into
circumflex a
left anterior descedning a
what does circumflex ca supply
’’’
left atrium
posterior L ventricle
what des left anterior desc artery supply
ant L ventricle
anterior septal area
symptoms of ACS
central chest pain N&V sweating, clamminess SOB palpitation pain jaw, arm
STEMI ECG features
ST elevation
new left bundle branch block
NSTEMI ECG features
ST depression
T wave inversion
pathological Q waves
L coronary artery occlusion
anterolateral
I, aVL, V3-V6
left anterior descending occlusion
anterior
V1-V4
circumflex occlusion
lateral
I, aVL, V5, V6
right coronary artery occlusoin
inferior
II, III, aVL
alternative causes raised troponin
chronic renal failure sepsis PE aortic dissection myocarditis
investtigations
ECG troponin FBC U&Es LFTs lipids, HbA1c, thyroid ECHO CXR CTCA
acute STEMI treatment
primary PCI if available within 2hr presentation
thrombolysis if outwith 2hrs
acute NSTEMI treatment
beta blocker aspirin DOACs morphine anticoagulant GTN
GRACE score
assess for PCI in NSTEMI
6mo risk death or repeat MI after NSTEMI
MI complications
death,
septum/papillary muscle rupture,
arrythmia,
dressler’s syndrome,
dressler’s syndrome
2-3wks after MI
localised immune response causes pericarditis
dressler’s syndrome clinical
pleuritic chest pain
fever
pericardial rub
dressler’s syndrome diagnosis
ECG - ST elevation, T wave inversion
ECHO
inc CRP
dressler’s syndrome management
NSAIDs
steroids
2ry prevention
dual anticoagulant - aspirin, ticagrelol
statin
ACEI
beta blocker
2ry prevention lifestyle
stop smoking
less alcohol
diet
cardiac rehab
type 1 MI
‘traditional’
due to coronary event
type 2 MI
ischaemia due to inc demand or drop supply O2
severe anemia, hypotension etc
type 3 MI
sudden cardiac death
type 4 MI
assoc w PCI/stenting/CABG
