Acute Coronary Syndrome Flashcards
What is the Glagov Phenemenon?
Luminar narrowing is a late phase finding of ASCVD due to outward protruding of atherosclerosis of lumen.
Incidence of 1st (+) EKG in ACS?
<50%
Time limit for PCI for patent presenting with ACS?
90 minutes
Time limit for fibrinolytic for patent presenting with ACS?
30 minutes
Time limit for to transfer patent presenting with ACS, being transferred to PCI-capable facility?
- 30 minutes for DIDO (Door-In-Door-Out)
- 120 minutes from FMC (First Medical Contact)
Treatment for patient presenting to non-PCI-capable facility outside of time window?
- If in cardiogenic shock, or lytics CI’ed, then transfer.
- If no cardiogenic shock, give lytics, and then transfer (“Drip and Ship”
Absolute contraindications to lytics (8)?
- Prior ICH
- Known structural intracranial lesion (aneurysm)
- Intracranial neoplasm
- Ischemic CVA <3 mo
- Significant head trauma <3 mo
- Intracranial / spinal surgery <2mo
- Suspect / known aortic dissection
- Active bleeding / diathesis
Relative contraindications to lytics (8)?
- SBP > 180
- CVA > 3mo
- CPR > 10 minutes
- Major surgery < 3 weeks
- Internal bleeding <4 weeks
- Noncompressible vascular puncture
- Pregnncy
- Concurrent use of blood thinners
Ischemic CVA within how long is an absolute contraindication to fibrinolytics?
3 months
Significant head trauma within how long is an absolute contraindication to fibrinolytics?
3 months
Intracranial / spinal surgery within how long is an absolute contracindication to fibrinolytics?
2 months
SBP limit for fibrinolytics?
180
CPR time limit for fibrinolytic adminsitration?
10 minutes
Major surgery within how long is a relative contraindication to fibrinolytics?
3 weeks
Indications for CCBs in ACS patients?
- Contraindications to BB
- Recurrent ischemia after BB / morphine givn
