Acute Coronary Syndrome

Question 1

Acute coronary syndrome (ACS)

Answer 1

• a range of conditions associated with sudden, reduced blood flow to the heart
• If Ischemia continues and is not reversed, acute coronary syndrome (ACS) develops.
• caused by the decline of a once stable atherosclerotic plaque
• range of conditions associated with sudden, reduced blood flow to the heart.

Question 2

NSTEMI

STEMI

Answer 2

• non–ST-segment–elevation myocardial infarction

* ST-segment–elevation myocardial infarction

Question 3

Unstable angina

Answer 3

• chest pain that is new in onset, occurs at rest, or has a worsening pattern
• This unstable lesion may be partially occluded by a thrombus
•
Stable angina has a regular pattern. Unstable angina does not follow a pattern and can happen without physical exertion.

Question 4

ST-segment–elevation myocardial infarction

Answer 4

a classic heart attack. It is one type of myocardial infarction in which a part of the heart muscle (myocardium) has died due to the obstruction of blood supply to the area.
• This unstable lesion may be totally occluded by a thrombus

Question 5

non–ST-segment–elevation myocardial infarction

Answer 5

• a less severe form of heart attack than the STEMI because it inflicts less damage to the heart.
• This unstable lesion may be partially occluded by a thrombus

Question 6

Myocardial Infarction

Answer 6

Heart attack.

when blood flow to the heart muscle is blocked.

The degree of altered function depends on the area of the heart involved and the size of the infarct.

Contractile function of the heart is disrupted in areas of myocardial necrosis.

Most MIs involve the left ventricle (LV).

Question 7

Ventricular remodelling

Answer 7

Normal myocardium will hypertrophy and dilate in an attempt to compensate for the infarcted muscle.

Question 8

Acute pericarditis

Answer 8

is inflammation of the pericardium

Question 9

Dressler Syndrome

Answer 9

• type of inflammation of the sac surrounding the heart

* pericarditis with effusion and fever that develop 4–6 weeks after MI

Question 10

Emergent Percutaneous Coronary Intervention

Answer 10

• first-line treatment for patients with confirmed STEMI
• Balloon angioplasty + drug-eluting stent(s)
• patient undergoes cardiac catheterization to locate and assess the severity of the blockage
• a bare metal stent is inserted into the blocked coronary artery

Question 11

Thrombolytic (fibrinolytic) therapy

Answer 11

• indicated only for patients with an STEMI.
• limit the infarction size by dissolving the thrombus in the coronary artery and prepare the heart muscle for reperfusion
• Best marker of reperfusion: return of ST segment to baseline
• Major complication: bleeding

Question 12

CABG surgery

Coronary artery bypass graft

Answer 12

• consists of the placement of arterial or venous grafts to provide blood flow between the aorta or other major arteries and the heart muscle distal to the blocked coronary artery (or arteries)
• Requires a sternotomy (opening of the chest cavity) and cardiopulmonary bypass (CPB).

Also Minimally invasive direct coronary artery bypass (MIDCAB)

Question 13

Nitroglycerin

Answer 13

vasodilator

Question 14

ECG: T-wave inversion

Answer 14

zone of ishemia

Question 15

ECG: ST wave elevation

Answer 15

zone of injury

Question 16

ECG: abnormal Q wave

Answer 16

zone of necrosis

Question 17

SUDDEN CARDIAC DEATH (SCD)

Answer 17

• Unexpected death from cardiac causes
• Abrupt disruption in cardiac function, resulting in loss of CO and cerebral blood flow
• Death usually within 1 hour of onset of acute symptoms (e.g., angina, palpitations)
• Most SCDs are caused by ventricular dysrhythmias