Acute Coronary Syndrome Flashcards
What is meant by Acute Coronary Syndrome?
Acute coronary syndrome refers to a range of conditions which result from the formation of a thrombus on a atheromatous plaque in a coronary artery.
What are the 3 conditions that use the umbrella term ACS?
STEMI, NSTEMI and Unstable Angina
What signs are used to differentiate between the 3 conditions?
Clinical presentation, ECG changes and biochemical cardiac markers.
How does a STEMI present within the arteries and during diagnostic testing?
A STEMI presents with complete blockage of the artery resulting in myocardial tissue injury and ST wave elevation shown on the ECG.
How does a NSTEMI present within the arteries and during diagnostic testing?
A NSTEMI presents with partial or intermittent blockage of the artery resulting in myocardial tissue injury with ST wave depression, T wave inversion or normal shown on the ECG.
How does Unstable Angina present within the arteries and during diagnostic testing?
Unstable angina presents with partial or intermittent blockage of the artery with no myocardial tissue injury with ST wave depression, T wave inversion or normal shown on the ECG.
What is the biochemical cardiac marker used to indicate myocardial tissue injury?
Troponin is used to observe where myocardial tissue injury occurs or not.
How would you differentiate between the conditions in terms of diagnostic testing results?
STEMI - ST elevation, High elevation of Troponin Level
NSTEMI - ST depression, T wave inversion, Normal and Low elevation of Troponin Level
UA - ST depression, T wave inversion, Normal and Normal Troponin Level
What are the 6 symptoms experienced by patients with experiencing ACS?
Chest pain
SOB
Sweating
Nausea/Vomiting
Dizziness
Fatigue
What drugs are used for in the blood initial management of ACS? (Give examples)
Nitrates (GTN)
IV Morphine
Anti-platelets (Aspirin)
Fibrinolytic’s (Streptokinase)
LMWH (Fondaparinux)
UFH
What drugs are often used in the secondary prevention of ACS events?
ACE inhibitors
Beta-blockers
Anti-platelet therapy
Statins
What non-drug treatment may be used in the management of ACS?
Percutaneous coronary intervention (PCI)
Coronary artery bypass graft (CABG)
What does a PCI procedure pertain?
Catheter is inserted into artery through groin or wrist and is guided to heart a small balloon is inflated at the sight of blockage, which opens the artery and restores blood flow then a stent is placed to keep the artery open.
What does a CABG procedure pertain?
This involves creating new routes for blood to flow around blocked/ narrow arteries, by taking healthy blood vessels from other parts of the body and grafting it onto the coronary artery allowing blood to bypass.
