Acute Coronary Syndrome Flashcards
What does ACS refer to
myocardial ischaemia with or without infarction
what are the three categories of ACS
unstable angina (UA), STEMI and NSTEMI
how is ACS organised into three categories
presence of ST elevation on the ECG, cardiac biomarkers such as troponin and creatine kinase
what is unstable angina
no biochemical info;
prolonged (>20 mins) angina, new sudden severe onset of angina, angina with longer frequency or duration or if the angina occurs after a recent myocardial infarction
in unstable angina, what will you see on the ECG
usually ST segment depression and T wave inversion but can be normal
in unstable angina what will you see regarding cardiac biomarkers
not raised
what is a STEMI; ECG and biomarkers?
if there’s persistent ST segment elevation in 2 or more continuous leads or if there’s a new left bundle branch block. cardiac markers will be raised
treatment of a STEMI
Immediate and prompt revascularisation with percutaneous coronary intervention within 90 minutes of first presentation, or thrombolysis within 12 hours of symptom onset
aim of STEMI treatment
can prevent or decrease myocardial damage and decrease morbidity and mortality by preventing acute complications
what is an NSTEMI
acute ischaemic event caused by myocyte necrosis
ECG changes in NSTEMI
ECG may show ST-segment depression, transient ST-segment elevation, or T-wave inversion; however, it may also be normal or show non-specific changes.
cardiac biomarkers in NSTEMI
raised creatine kinase- MB and troponin
difference between UA and NSTEMI
cardiac biomarkers are elevated at presentation or after several hours in NSTEMI, but are normal on serial measurement in UA
treatment of NSTEMI
Treatment is directed towards relief of ischaemia, prevention of further thrombosis or embolism, and stabilisation of haemodynamic status, followed by early risk stratification for further treatment.
