Acute Coronary Syndrome Flashcards
1
Q
stable angina
A
-
2
Q
stable angina
A
-
3
Q
unstable angina
A
-
4
Q
non modifiable risk factors
A
-
5
Q
modifiable risk factors
A
-
6
Q
oral contraceptives as a risk factor for clotting
A
-
7
Q
risk factors for CAD
A
-
8
Q
What does increase blood sugar do?
A
cause damage to your vasculature
9
Q
homocysteine levels
A
5-15 = normal
10
Q
c-reactive protein
A
normal = 1 mg
11
Q
If total cholesterol is >260 ____X the risk for CAD
A
-
12
Q
Total Cholesterol HDL LDL TG HDL:LDL ratio VLDL
A
13
Q
Which angina has a thick fibrous cap protecting it?
A
Stable
14
Q
Questions for unstable angina
A
“Is this chest pain like you have had before?” -much worse
“when did it occur”
I woke up with it
15
Q
Thin fibrous caps breaks
A
unstable angina
16
Q
first thing to reach for at home if you have never had chest pain
A
aspirin
17
Q
Angina relieved by 1 nitroglycerin
A
stable
18
Q
Which type of angina can occur with clean arteries?
Why
What EKG association
A
Variant
It is a spasm
ST elevation
19
Q
Slient ischemia
A
Not everyone has severe pain with a heart attack
20
Q
Who is more likely to have silent ischemia
A
diabetics
21
Q
Women’s angina symptoms
A
-
22
Q
Go ahead and get a _ ____ ___ for someone short of breath
A
12 lead EKG
23
Q
MI: time is _______
A
muscle
24
Q
Cardiac cells can withstand ischemia for ____ min before necrosis
A
20
25
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
26
MI: Injury
due to decreased blood supply (Returns to normal as injury heals)
-Elevated ST
27
Infarction
due to scar tissue that cannot depolarize
will usually remain on 12 lead ECG
-pathological Q wave
28
Pathological Q wave
wider and longer or changing
| Always indicative of MI (previous or present)
29
NSTE-MI
Non ST elevation MI
Infarction not full thickness
Less likely to have Q waves
Treatment is still aggressive
30
STE-MI
-
31
Transmural
-
32
Non Transmural
-
33
Anterior Infarction
Vessel: LAD
Leads: V3 - V4
34
Inferior Infarction
Vessel: RCA
Leads: II, III, AVF
35
Know the order of when to look at biomarkers and when they occur (slide 31)
-
36
When would you check the biomarkers
Admission
4 hours
4 hours
37
M
O
N
A
Morphine
Oxygen
Nitrate
Aspirin
38
Who gets the t-PA drugs?
Someone who lives in an area that doesnt have the ability to get PCI in 30 minutes
39
What is PCL
-
40
What does Aspirin do
-
41
What does heparin do
-
42
Intensive glucose therapy: why do we went glucose down?
We want glucose down
1. Less chance of infection
2. Less irritability of the vessel
3. Prevent ventricular remodling
43
Which coronary causes a inferior wall MI
Right Coronary
44
know pulmonary
| edema
-
45
short or breath what does nurse do first =
raise head of bed
46
ST elevation in all 12 leads =
-
47
When can i resume normal sexual activity after MI?
When you can climb 2 flights of stairs without getting short of breath
48
cell saver
-
49
cardiac tamponade
muffled heart tones
sudden decrease in chest tube drainage
widening cardiac silouette on CXR
50
management slide 69
-
51
CABG STROKE RISK
stroke from bypass machine thrombus
52
who is at risk for cardiogenic shock
MI
surgical patient
dysrhythmia
53
symptoms of cardiogenic shock
low CO
SOB
fast HR
54
clinical manifestations of cardiogenic shock
-
55
Where should you put vasopressors for cargiogenic shock
central line
56
What does IABP do
reduces afterload
| improves coronary circulation
57
When does balloon pump inflate?
During diastole
58
What does IABO do when it inflates?
helps perfuse coronary arteries
59
KNow safety issues IABP
- bleeding
- occlusion (distal)
- perforation
- infection
60
NI for safety of balloon pump
- watch I&O
| - watch pulses
61
know IABP waveforms slide 97
-
62
unstable angina
-
63
non modifiable risk factors
-
64
modifiable risk factors
-
65
oral contraceptives as a risk factor for clotting
-
66
risk factors for CAD
-
67
What does increase blood sugar do?
cause damage to your vasculature
68
homocysteine levels
5-15 = normal
69
c-reactive protein
normal = 1 mg
70
If total cholesterol is >260 ____X the risk for CAD
-
71
```
Total Cholesterol
HDL
LDL
TG
HDL:LDL ratio
VLDL
```
72
Which angina has a thick fibrous cap protecting it?
Stable
73
Questions for unstable angina
"Is this chest pain like you have had before?" -much worse
"when did it occur"
I woke up with it
74
Thin fibrous caps breaks
unstable angina
75
first thing to reach for at home if you have never had chest pain
aspirin
76
Angina relieved by 1 nitroglycerin
stable
77
Which type of angina can occur with clean arteries?
Why
What EKG association
Variant
It is a spasm
ST elevation
78
Slient ischemia
Not everyone has severe pain with a heart attack
79
Who is more likely to have silent ischemia
diabetics
80
Women's angina symptoms
-
81
Go ahead and get a _ ____ ___ for someone short of breath
12 lead EKG
82
MI: time is _______
muscle
83
Cardiac cells can withstand ischemia for ____ min before necrosis
20
84
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
85
MI: Injury
due to decreased blood supply (Returns to normal as injury heals)
-Elevated ST
86
Infarction
due to scar tissue that cannot depolarize
will usually remain on 12 lead ECG
-pathological Q wave
87
Pathological Q wave
wider and longer or changing
| Always indicative of MI (previous or present)
88
NSTE-MI
Non ST elevation MI
Infarction not full thickness
Less likely to have Q waves
Treatment is still aggressive
89
STE-MI
-
90
Transmural
-
91
Non Transmural
-
92
Anterior Infarction
Vessel: LAD
Leads: V3 - V4
93
Inferior Infarction
Vessel: RCA
Leads: II, III, AVF
94
Know the order of when to look at biomarkers and when they occur (slide 31)
-
95
When would you check the biomarkers
Admission
4 hours
4 hours
96
M
O
N
A
Morphine
Oxygen
Nitrate
Aspirin
97
Who gets the t-PA drugs?
Someone who lives in an area that doesnt have the ability to get PCI in 30 minutes
98
What is PCL
-
99
What does Aspirin do
-
100
What does heparin do
-
101
Intensive glucose therapy: why do we went glucose down?
We want glucose down
1. Less chance of infection
2. Less irritability of the vessel
3. Prevent ventricular remodling
102
Which coronary causes a inferior wall MI
Right Coronary
103
know pulmonary
| edema
-
104
short or breath what does nurse do first =
raise head of bed
105
ST elevation in all 12 leads =
-
106
When can i resume normal sexual activity after MI?
When you can climb 2 flights of stairs without getting short of breath
107
cell saver
-
108
cardiac tamponade
muffled heart tones
sudden decrease in chest tube drainage
widening cardiac silouette on CXR
109
management slide 69
-
110
CABG STROKE RISK
stroke from bypass machine thrombus
111
who is at risk for cardiogenic shock
MI
surgical patient
dysrhythmia
112
symptoms of cardiogenic shock
low CO
SOB
fast HR
113
clinical manifestations of cardiogenic shock
-
114
Where should you put vasopressors for cargiogenic shock
central line
115
What does IABP do
reduces afterload
| improves coronary circulation
116
When does balloon pump inflate?
During diastole
117
What does IABO do when it inflates?
helps perfuse coronary arteries
118
KNow safety issues IABP
- bleeding
- occlusion (distal)
- perforation
- infection
119
NI for safety of balloon pump
- watch I&O
| - watch pulses
120
know IABP waveforms slide 97
-
