Acute Coronary Syndrome Flashcards
stable angina
-
stable angina
-
unstable angina
-
non modifiable risk factors
-
modifiable risk factors
-
oral contraceptives as a risk factor for clotting
-
risk factors for CAD
-
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
-
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
-
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
-
Transmural
-
Non Transmural
-
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)
-
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
-
What does Aspirin do
-
What does heparin do
-
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
-
short or breath what does nurse do first =
raise head of bed
ST elevation in all 12 leads =
-
When can i resume normal sexual activity after MI?
When you can climb 2 flights of stairs without getting short of breath
cell saver
-
cardiac tamponade
muffled heart tones
sudden decrease in chest tube drainage
widening cardiac silouette on CXR
management slide 69
-
CABG STROKE RISK
stroke from bypass machine thrombus
who is at risk for cardiogenic shock
MI
surgical patient
dysrhythmia
symptoms of cardiogenic shock
low CO
SOB
fast HR
clinical manifestations of cardiogenic shock
-
Where should you put vasopressors for cargiogenic shock
central line
What does IABP do
reduces afterload
improves coronary circulation
When does balloon pump inflate?
During diastole
What does IABO do when it inflates?
helps perfuse coronary arteries
KNow safety issues IABP
- bleeding
- occlusion (distal)
- perforation
- infection
NI for safety of balloon pump
- watch I&O
- watch pulses
know IABP waveforms slide 97
-
unstable angina
-
non modifiable risk factors
-
modifiable risk factors
-
oral contraceptives as a risk factor for clotting
-
risk factors for CAD
-
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
-
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
-
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
-
Transmural
-
Non Transmural
-
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)
-
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
-
What does Aspirin do
-
What does heparin do
-
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
-
short or breath what does nurse do first =
raise head of bed
ST elevation in all 12 leads =
-
When can i resume normal sexual activity after MI?
When you can climb 2 flights of stairs without getting short of breath
cell saver
-
cardiac tamponade
muffled heart tones
sudden decrease in chest tube drainage
widening cardiac silouette on CXR
management slide 69
-
CABG STROKE RISK
stroke from bypass machine thrombus
who is at risk for cardiogenic shock
MI
surgical patient
dysrhythmia
symptoms of cardiogenic shock
low CO
SOB
fast HR
clinical manifestations of cardiogenic shock
-
Where should you put vasopressors for cargiogenic shock
central line
What does IABP do
reduces afterload
improves coronary circulation
When does balloon pump inflate?
During diastole
What does IABO do when it inflates?
helps perfuse coronary arteries
KNow safety issues IABP
- bleeding
- occlusion (distal)
- perforation
- infection
NI for safety of balloon pump
- watch I&O
- watch pulses
know IABP waveforms slide 97
-
