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NUR 406 > acute coronary syndrome > Flashcards

acute coronary syndrome Flashcards

1
Q

Unstable angina (UA)

A

new or changing chest pain caused by ischemia.
those with angina for the first time are diagnosed with UA until cause of chest pain is determined.
more severe than normal.

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2
Q

STEMI

A

ST segment elevation myocardial infarction

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2
Q

NSTEMI

A

non-ST segment elevation myocardial infarction

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3
Q

Variant/Vasospastic Angina is also known as?

A

Prinzmetal angina

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4
Q

causes of Variant/Vasospastic Angina

A

Coronary artery spasm.
Endothelial dysfunction.

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5
Q

characteristics of Variant/Vasospastic Angina

A

CAD may or may not be present
Onset timing: Rest, minimal exertion, night.
Specific ECG changes: Elevated ST segment.

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6
Q

treatment for Variant/Vasospastic Angina

A

nitrates- relaxes spasms.

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7
Q

Unstable plaque leads to ACS: size of lipid core, inflammation, smooth muscle cells?

A

size of lipid core= large. inflammation= active; check CRP levels
smooth muscle cells= proliferation into intima

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8
Q

with unstable angina why is there no infarction?

A

the Occlusion is partial OR Thrombus dissolves.

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9
Q

are there any ECG changes with unstable angina?

A

Might see ischemic changes, typically transient

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10
Q

are cardiac enzymes elevated with unstable angina?

A

no

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11
Q

theory of plaque rupture

A

INCREASED SNS ACTIVITY: epi/norepi is released; ↑ BP, HR, & force of contraction, ↑ force of coronary artery blood flow, ↑ force exerted against injured endothelium.
PLAQUE RUPTURE.
Platelets adhere to ruptured plaque; Release substances that 1) attract more platelets
and 2) contribute to vasospasm.
THROMBUS FORMATION.

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12
Q

contributing factors to increased SNS activity

A

Psychological stress
Exercise
Circadian rhythms

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13
Q

signs of UA in men

A

discomfort in arms, back, neck, shoulder, or jaw.
chest pain, SOB

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14
Q

signs of UA in women

A

sudden dizziness
heartburn-like feeling
cold sweat
unusual tiredness
N/V

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15
Q

S/S of MI

A

Diaphoresis
Dyspnea
Extreme anxiety
Levine’s sign (fist to chest)
Pallor
Retrosternal crushing chest pain that radiates to shoulder, arm, jaw, or back
Weak pulses

16
Q

What is an acute myocardial infarction?

A

Ruptured plaque + thrombus.
Acute coronary syndrome (ACS) with prolonged ischemia without recovery.

17
Q

MI: Why is there an infarction?

A

Blood flow disruption is prolonged OR Blood flow disruption is total.

18
Q

Are there ECG changes with an acute MI?

A

yes

19
Q

are cardiac enzyme levels elevated during an acute MI?

A

Yes

20
Q

Myocardial cells suffer _ _ _.

A

irreversible ischemic necrosis.

21
Q

Irreversible injury occurs within …..

A

30 minutes to 4 hours

22
Q

tissue necrosis begins by _ hours

A

4

23
Q

necrotic tissue is cleared away by _ weeks

A

1-2

24
Q

Tough fibrous scar tissue replaces necrotic tissue by _ weeks?

A

6

25
Q

3 zones of damage

A

ischemia= full recovery possible
injury= some recovery possible, can still perfuse it & restore it to become viable
infarction= necrosis

26
Q

The extent of damage influenced by three factors:

A

location or level of occlusion
Length of time
Heart’s availability of collateral circulation.

27
Q

STEMI: describe ST segment, QRS, T wave, troponin, size of infarct, outcomes

A

ST segment: elevation
QRS: usually pathologic (wide), develops over hours
T wave: peaked then inverted
troponin: elevated
size of infarct: large
outcomes: poor

28
Q

NSTEMI: describe ST segment, QRS, T wave, troponin, size of infarct, outcomes

A

ST segment: depressed or normal
QRS: normal
T wave: inverted
troponin: elevated
size of infarct: smaller
outcomes: better

29
Q

which artery is most commonly involved in myocardial infarction?

A

Left Anterior Descending (LAD) Artery

NUR 406 (7 decks)

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