Acute Coronary Syndrome Flashcards
What is the persistence of cTnI?
3-10 days
What is the persistence of myoglobin?
24 hours
What is the persistence of cTnT?
7-10 days
What does ACS stand for?
acute coronary syndrome
What is the time to peak elevation of cTnT?
12-48 hours
What is the onset of detection of LD-I?
10-12 hours
Unstable angina?
discomfort which is new in onset or is increased in duration, frequency or intensity with less exertion or at rest compared to previous episodes of discomfort
How is STEMI treated?
- open the artery- give fibrinolytic if cath lab is >90 min away 2. reduce myocardial O2 demand w/ beta-blockers and nitrates (if stable)
What is STEMI?
Complete coronary vessel occlusion: ST elevation myocardial infarction (STEMI)
_____ is very sensitive and specific for myocardium.
Cardiac troponin
What is acute coronary syndrome (ACS)?
any array of clinical symptoms resulting from underlying acute myocardial ischemia
What is the persistence of LD-I?
7-10 days
How are NSTEMI or unstable angina treated?
halt the coagulation cascade (enoxaparin, heparins OR bival/thrombolytics) AND the platelet cascade (aspirin + P2Y12 inhibitor OR -ogrels OR GPIIb/IIIa inhibitor)
What is the onset of detection of cTnT?
4-6 hours
Partial coronary vessel occlusion, escalating symptoms without myocardial necrosis?
unstable angina
Stable angina?
present when there is increased demand for myocardial oxygen in a reproducible fashion
present when there is increased demand for myocardial oxygen in a reproducible fashion
stable angina
What is the onset of detection of myoglobin?
1-2 hours
What is the time to peak elevation of cTnI?
12 hours
What is the onset of detection of cTnI?
4-6 hours
What is the onset of detection of CK-MB isoforms?
4-6 hours
Dysfunctional endothelium + coagulation + platelet aggregation =
Coronary thrombosis
What is the persistence of CK-MB isoforms?
2-4 days
What is the time to peak elevation of LD-I?
48-72 hours
Causes of ACS?
Atherosclerotic plaque rupture with thrombus Coronary embolism Congenital anomalies Coronary trauma or aneurysm Severe coronary artery spasm (e.g. cocaine) Increased blood viscosity Spontaneous coronary dissection Markedly increased myocardial O2 demand
discomfort which is new in onset or is increased in duration, frequency or intensity with less exertion or at rest compared to previous episodes of discomfort
unstable angina
What is the time to peak elevation of CK-MB isoforms?
18 hours
What is NSTEMI?
Partial coronary vessel occlusion with myocardial necrosis: non ST elevation MI (NSTEMI)
any array of clinical symptoms resulting from underlying acute myocardial ischemia
acute coronary syndrome (ACS)
What is the time to peak elevation of myoglobin?
8-10 hours
