Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Patho 2 > Acute Coronary Syndrome > Flashcards

Acute Coronary Syndrome Flashcards

1
Q

Unstable angina pain characteristics

A

New or changing chest pain
- emergency–call 911
- get diagnosed with this if come in with chest pain until resolved

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

NSTEMI

A
  • partial blockage
  • depressed or normal ST
  • QRS normal
  • inverted T wave
  • elevated troponin
  • smaller infarct, better outcomes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

STEMI

A
  • complete blockage
  • elevated ST
  • wide QRS
  • peaked then inverted T wave
  • elevated troponin
  • larger infarct, worse outcomes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Differentiating factor between STEMI and NSTEMI

A

EKG changes for STEMI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Acute coronary syndrome

A

umbrella term for blockage of blood to the heart–tissue dying

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Prinzmetal variant angina char and tx

A
  • vasospasm often from damage to the endothelium or coronary vessel
  • may be at rest at night, not from exertion
  • CAD may/may not be present
  • may have elevated ST
  • beginning or cause of dysrhythmias
  • tx with nitrates and relaxes the spasm
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Unstable plaque

A
  • large lipid core with thin fibrous cap
  • lots of inflam and smooth muscle cell proliferation into the intima–risk of rupture
  • can use to monitor progress
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What lab measures unstable plaque

A

CRP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Unstable angina

A
  • ruptured plaque and thrombus
  • occlusion is partial or thrombus dissolves–no infarction
  • may be transient ECG changes
  • cardiac enzymes not elevated
  • more severe than chronic angina
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Theory of plaque rupture

A

Inc SNS activity–inc BP, HR, force of ctx–inc force of coronary artery BP–inc force exerted against injured endothelium–ruptured plaque–plt adhere to ruptured plaque (bc abnormality)–release subs that attract more plt and contribute to vasospasm–thrombus forms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

ACS vs stable angina

A
  • ACS lasts beyond 15 minutes
  • relief with nitrates when stable
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

ACS symptoms

A

impending doom, sweaty, tight chest, N?V

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Unstable angina symptoms in women

A

dizzy, heartburn, cold sweat, tired

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

MI symptoms

A

diaphoretic, dyspnea, anxiety, restless, pallor, retrosternal crushing chest pain to shoulder, arm, jaw, back, weak pulse, Levine’s sign (fist to chest)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Which artery is the widowmaker

A

Left anterior descending; supplies blood to the heart

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Acute MI

A

Ruptured plaque with thrombus
- ACS with prolonged ischemia w/o recovery
-BF disruption is prolonged OR BP disruption is total
- EKG chx that doesn’t go back to normal
- cardiac enzymes elevated
- prolonged ischemia w/o recovery or healing
- irreversible ischemic necrosis to myocardial cells

17
Q

Ischemia

A

O2 supply not meeting metabolic demands
- full recovery possible

18
Q

Infarction

A

Irreversible tissue death (necrosis)
- begins within 30 min to 4h

19
Q

Can ATP be stored?

A

No

20
Q

Cycle of ischemia to infarction

A
  • lack ATP w/i 1-2 min of poor oxygen supply
  • irreversible injury w/i 30min-4h (infarct)
  • tissue necrosis w/i 4h
  • necrotic tissue cleared in 1-2W
  • tough fibrous scar tissue replaces necrotic tissue in 6W
21
Q

Cardiac injury

A
  • some recovery possible
  • can still perfuse it and restore to become viable
  • not dead yet–inc oxygen and dec demand of heart
22
Q

What does extent of heart muscle damage depend on…

A
  • location of level of occlusion in coronary artery
  • length of time that artery has been occluded
  • heart’s availability of collateral circulation
23
Q

Immediate pharm for MI

A
  • oxygen first!
  • morphine to dec pain and inc dilation, dec preload and afterload
  • chewable aspirin–plt less sticky
  • nitroglycerin (IV if possible) to dec preload and afterload, limit infarct size
  • beta blockers if HR able to handle
24
Q

Giving thrombolytics

A

Need w/i 4-6h of chest pain if have a clot

25
Q

Alteplase

A
  • fibrinolytic therapy for STEMIs
  • converts plasminogen to plasmin
  • use w/i 30-70min of MI sx
  • main risk is bleed
  • CI with brain bleed
26
Q

What meds can be given with alteplase?

A

Heparin and clopidogrel

27
Q

Nitroglycerin NC and SE

A
  • SE hypotension, HA, flush
  • CI with sildenafil for severe hypotension
28
Q

Reperfusion injury

A

Injured tissue gets blood again suddenly and it shocks the tissue, causing heart failure
- from oxidized free radicals generated by WBCs and cell response to restored BP

29
Q

What can reperfusion injuries lead to?

A

Reperfusion dysrhythmias like v fib and v tach

Patho 2 (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions