Acute Coronary Syndrome Flashcards
Evaluates specific and general ventricular performance, regional wall motion, and
ejection fraction
Cardiac blood imaging/Multiple-gated Acquisition (MUGA) Scan
includes the description of the presenting symptoms, the
history of previous cardiac and other illnesses, and the family history of heart
diseases.
Patient history
Because of increased oxygen demand and a decrease in the supply
of oxygen, ** occurs.
shortness of breath
present as a result of the stimulation of sympathetic nervous
system.
Indigestion.
To compensate for the decreased oxygen supply,
Tachycardia and tachypnea
Evaluates specific and general ventricle performance, regional wall motion, and
ejection fraction.
MUGA
CPK-MB (isoenzyme in cardiac muscle): Elevates within 4–8 hr, peaks in 12–20 hr,
returns to normal in 48–72 hr.
Cardiac enzymes and isoenzymes
May reveal abnormal valvular action as cause of chest pain.
Echocardiogram
CAUSES of MI
Atherosclerosis
Embolism
contraindication of nitroglycerin
Erection-enhancing medicine such as sildenafil
(Viagra), tadalafil (Cialis), and vardenafil (Levitra). Combining nitroglycerin
Thallium-201: Ischemic regions appear as areas of decreased thallium uptake.
Nuclear imaging studies (rest or stress scan)
reduce pain and anxiety, also has other
beneficial effects as a vasodilator and decreases the workload of the heart by
reducing preload and afterload.
Morphine
to avoid intense straining that may trigger arrhythmias or another cardiac
arrest.
Stool Softeners
s prevent thrombus formation
Anticoagulants
The patient may need reminders about follow-up
monitoring, including periodic blood laboratory testing
Follow-up monitoring.
Visualizes narrowing/occlusion of coronary arteries and is usually done in
conjunction with measurements of chamber pressures and assessment of left
ventricular function (ejection fraction). Procedure is not usually done in acute
phase of MI unless angioplasty or emergency heartsurgery
Coronary angiography
heart pumps more and more blood to compensate the decreased
oxygen supply, and the cardiac muscle would ultimately fail leading to ***
Cardiac arrest.
placed in a dark-colored (such as
brown), airtight, glass container that cannot see through. Keep the
container tightly closed. Keep nitroglycerin pills and liquid spray away from
heat or moisture
can precipitate an attack by increasing myocardial oxygen demand
Physical exertion
Imbalances of sodium andpotassiumcan alter conduction and compromise
contractility.
Electrolytes
o Evaluates myocardial blood flow and status of myocardial cells, e.g.,
location/extent of acute/previous MI.
Nuclear imaging studies: Persantine or Thallium
symptoms increase in frequency and severity and may not be
relieved with rest or nitroglycerin.
Unstable angina
prevents the formation of thromboxane A2 which causes platelets to
aggregate and arteries to constrict. The earlier the patient receives ASA after
symptom onset, the greater the potential benefit.
Aspirin
Leukocytosis (10,000–20,000) usually appears on the second day after MI because
of the inflammatory process.
WBC
ASSESSMENT AND DIAGNOTICS
ECG
24-hour ECG monitoring (Holter)
Cardiac enzymes
Chest x-ray
PCo2, potassium, and myocardial lactate
Serum lipids
MUGA
Echocardiogram
Ergonovine (Ergotrate) injection
Usually within normal limits (WNL); elevation indicates myocardial damage
Cardiac enzymes (AST, CPK, CK and CK-MB; LDH and Isoenzymes LD1, LD2)
five (5) classifications or types of angina:
Stable angina.
Unstable angina
Intractable or refractory angina.
Vasospastic Angina/Prinzmetal Angina/Variant angina
Silent ischemia
Usually normal; however, infiltrates may be present, reflecting cardiac
decompensation or pulmonary complications.
Chest x-ray
often felt deep in the chest behind the sternum and may radiate to
the neck, jaw, and shoulders. is usually relieved by rest unlike in MI.
chest pain
causes the release of catecholamines, which increased blood pressure, heart
rate, and myocardial workload.
Stress
A heme protein of small molecular weight that is more rapidly released from
damaged muscle tissue with elevation within 2 hr after an acute MI, and peak
levels occurring in 3– 15 hr.
Myoglobin
CAUSES of Angina pectoris
Physical exertion
Exposure to cold.
Eating a heavy meal
Stress.
A catheter is inserted into the
blood vessels either in the
***
groin or in the arm.
increase in oxygen demand could cause shortness of breath.
Shortness of breath
Rises on second or third day after MI, indicating inflammatory response
Erythrocyte Sedimentation Rate (ESR)
May be elevated (CAD risk factor).
Serum lipids (total lipids, lipoprotein electrophoresis, and isoenzymes cholesterols [HDL,
LDL, VLDL]; triglycerides; phospholipids)
These enzymes have increased
specificity for necrosis and are therefore useful in diagnosing postoperative MI
when MB-CPK maybe elevated related to skeletal trauma.
Troponin I (cTnI) and troponin T (cTnT):
health educations for angina
Reduce anginal attacks.
Follow-up monitoring
Adherence.
he cardinal symptom of MI. Persistent and crushing substernal pain
that may radiate to the left arm, jaw, neck, or shoulder blades.
Chest pain
MI can arise from any condition in which the myocardial oxygen supply can’t keep pace with
demand, including:
Coronary Artery Disease (CAD)
. coronary artery emboli
. thrombus
. congenital coronary artery anomalies.
May indicate hypoxia or acute/chronic lung disease processes.
ABGs/Pulse oximetry
ST elevation signifying ischemia; peaked upright or inverted T wave
indicating injury; development of Q waves signifying prolonged ischemia or
necrosis
ECG