Acute Coronary Syndrome Flashcards
State the signs and symptoms of acute coronary syndrome (ACS).
Central chest pain, dyspnea, diaphoresis, nausea, vomiting, palpitations, syncope; atypical symptoms include fatigue, epigastric pain, or confusion especially in elderly, women, and diabetics.
State the investigations for acute coronary syndrome (ACS).
ECG, cardiac biomarkers (troponin I/T), chest X-ray, echocardiography, coronary angiography, blood tests (CBC, renal panel, coagulation profile, lipid profile).
State the management of acute coronary syndrome (ACS).
MONA-BASH (Morphine, Oxygen, Nitrates, Aspirin, Beta-blocker, Anticoagulation, Statin, Heparin), PCI or thrombolysis for STEMI, risk stratification and medical/invasive management for NSTEMI/UA, long-term therapy with DAPT and risk factor control.
State the complications of acute coronary syndrome (ACS).
Arrhythmias, heart failure, cardiogenic shock, myocardial rupture, pericarditis, Dressler’s syndrome, recurrent MI, thromboembolism, sudden cardiac death.
What are cardinal symptoms of ACS?
Chest pain, dyspnea, diaphoresis, nausea, palpitations.
What symptom may be absent in diabetics and elderly with ACS?
Chest pain.
What ECG finding is diagnostic of STEMI?
ST elevation in 2 contiguous leads or new LBBB.
What ECG changes suggest NSTEMI or unstable angina?
ST depression, T wave inversion, or normal ECG.
Which biomarker is most specific for myocardial injury?
Troponin I or T.
What does a normal troponin with angina symptoms suggest?
Unstable angina.
What investigation is the gold standard for coronary artery visualization?
Coronary angiography.
What is the role of echocardiography in ACS?
Assess LV function and detect wall motion abnormalities.
What does MONA-BASH stand for in ACS management?
Morphine, Oxygen, Nitrates, Aspirin, Beta-blocker, Anticoagulant, Statin, Heparin.
When is PCI indicated in STEMI?
Within 90 minutes of first medical contact.
When is thrombolysis considered in STEMI?
If PCI is not available within 120 minutes.
What is DAPT and why is it important in ACS?
Dual antiplatelet therapy (aspirin + clopidogrel/ticagrelor) to prevent re-thrombosis.
What syndrome occurs post-MI with fever and pericarditis?
Dressler’s syndrome.
What is the difference between STEMI and NSTEMI in terms of infarct depth?
STEMI = transmural; NSTEMI = subendocardial.
What score is used to risk stratify NSTEMI patients?
GRACE score.
What lifestyle changes are crucial after ACS?
Smoking cessation, healthy diet, regular exercise, weight control.
What is the main goal of acute ACS management?
Restore coronary perfusion quickly to limit myocardial damage.
