Acute Coronary Syndrome Flashcards
Angina Duration
Between 2 and 10 minutes
Unstable Angina duration
10-20 minutes
Acute MI duration
Variable; often >30 min
Quality of angina, unstable angina, and acute MI
Pressure, tightness, heaviness and burning; unstable and acute are more severe
Angina location
Retrosternal, often with radiation to or isolated discomfort in neck, jaw, shoulders, or arms (frequently the left)
Chest pain precipitated by exertion, exposure to cold, psychologic stress
Stable Angina
Chest pain similar to angina but occurs with low levels of exertion or even at rest
Unstable angina
Chest pain unrelieved with nitroglycerin that may be associated with HF or arrhythmias
Acute MI
Stable angina is relived with
Rest
Unstable angina EKG presentation
ST depression and T wave inversion
Coronary Artery Disease without chest pain
Silent ischemia
Three types of ACS
Unstable angina, NSTEMI, and STEMI
ECG changes with ACS
ST segment elevations during the painful episodes
Term applied to patients in whom there is a suspicious or confirmation of acute myocardial ischemia or infarction due to decreased oxygen supply and/or increased demand
Acute Coronary Syndrome (ACS)
Distinguishing unstable angina and NSTEMI
Troponin sensitivity biomarker test
Angina characteristics
Symptoms of ACS, may have EKG changes
NSTEMI characteristics
Symptoms of ACS, elevation of troponin, may have EKG changes
Elevation in troponin (w/ NSTEMI) may take up to ___ hrs to show up after symptoms
3
EKG changes associated with NSTEMI
ST segment depression, T wave changes, transient ST elevation
Characteristics of vasospastic angina
Occurs at rest or when sleeping, associated with Raynaud’s, sudden pain d/t coronary vasopasm (underlying problem is vasospasm), transient ST elevations and normal ECG changes between episodes
3 core elements of establishing diagnosis for vasospastic angina
Nitrates responsive angina, transient ischemic ECG changes in the absence of obvious causes for increased myocardial O2 demand, angiographic evidence of spasm
STEMI ECG
ST elevation
NSTEMI ECG
ST depression, T inversion
Inferior wall EKG leads
II, III, aVF
Anterior wall leads
V1-V4
Lateral wall leads
I, V5, V6, aVL
Part of heart affected with inferior wall MI
Right Coronary Artery (RCA)
Part of heart affected with anterior wall MI
Left anterior descending (LAD)
Part of heart affected with lateral wall MI
Circumflex
High lateral wall leads
I, aVL
Low lateral wall leads
V5-V6
