Acute Coronary Syndrome Flashcards
stable angina
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stable angina
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unstable angina
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non modifiable risk factors
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modifiable risk factors
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oral contraceptives as a risk factor for clotting
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risk factors for CAD
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What does increase blood sugar do?
cause damage to your vasculature
homocysteine levels
5-15 = normal
c-reactive protein
normal = 1 mg
If total cholesterol is >260 ____X the risk for CAD
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Total Cholesterol HDL LDL TG HDL:LDL ratio VLDL
Which angina has a thick fibrous cap protecting it?
Stable
Questions for unstable angina
“Is this chest pain like you have had before?” -much worse
“when did it occur”
I woke up with it
Thin fibrous caps breaks
unstable angina
first thing to reach for at home if you have never had chest pain
aspirin
Angina relieved by 1 nitroglycerin
stable
Which type of angina can occur with clean arteries?
Why
What EKG association
Variant
It is a spasm
ST elevation
Slient ischemia
Not everyone has severe pain with a heart attack
Who is more likely to have silent ischemia
diabetics
Women’s angina symptoms
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Go ahead and get a _ ____ ___ for someone short of breath
12 lead EKG
MI: time is _______
muscle
Cardiac cells can withstand ischemia for ____ min before necrosis
20
MI: Ischemia
The beginning of the lack of oxygen flow to the heart due to lack of depolarization
T wave inversion or
Tall peaked T wave, or ST depression
MI: Injury
due to decreased blood supply (Returns to normal as injury heals)
-Elevated ST
Infarction
due to scar tissue that cannot depolarize
will usually remain on 12 lead ECG
-pathological Q wave
Pathological Q wave
wider and longer or changing
Always indicative of MI (previous or present)
NSTE-MI
Non ST elevation MI
Infarction not full thickness
Less likely to have Q waves
Treatment is still aggressive
STE-MI
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Transmural
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Non Transmural
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Anterior Infarction
Vessel: LAD
Leads: V3 - V4
Inferior Infarction
Vessel: RCA
Leads: II, III, AVF
Know the order of when to look at biomarkers and when they occur (slide 31)
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When would you check the biomarkers
Admission
4 hours
4 hours
M
O
N
A
Morphine
Oxygen
Nitrate
Aspirin
Who gets the t-PA drugs?
Someone who lives in an area that doesnt have the ability to get PCI in 30 minutes
What is PCL
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What does Aspirin do
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What does heparin do
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Intensive glucose therapy: why do we went glucose down?
We want glucose down
- Less chance of infection
- Less irritability of the vessel
- Prevent ventricular remodling
Which coronary causes a inferior wall MI
Right Coronary
know pulmonary
edema
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short or breath what does nurse do first =
raise head of bed
ST elevation in all 12 leads =
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When can i resume normal sexual activity after MI?
When you can climb 2 flights of stairs without getting short of breath
cell saver
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