Acute Coronary Syndrome Flashcards
Plaque disruption leads to
atherothrombosis formation
Atherothrombosis is an unpredictable process caused by
unstable plaques
thrombosis
blood clot
most common cause of acute coronary syndrome
atherothrombosis
list of acute coronary syndromes
ST elevation MI
Non ST elevation MI
Unstable angina
sudden cardiac death
Risk factors
non-modifiable
age
gender
family history of ACS
Risk factors
modificable
smoking
hypertension
hyperlipidaemia
obesity
sedentary lifestyle
Why do plaques rupture?
inflammation
ACS will almost always give symptoms at….
rest
not like stable angina
History of ACS
character of pain
often tight band / pressure/ heaviness
History of ACS
radiation sites
jaw
arms
neck
History of ACS
location of pain
retrosternal
History of ACS
aggravated on…
exertion, emotional stress
Unstable angina and ST elevation MI
ECG
may be normal but
ST segment depression or elevation
Cardiac biomarker
troponin
unstable angina and NSTEMI immediate treatment
MONA
M - morphine
O - Oxygen
N - Nitroglycerine (GTN spray)
A - Aspirin
Anti-thrombotic therapy
IV heparin
Unstable angina and NSTEMI treatment (drugs)
beta blockers
Statins
ACE inhibitors
unstable angina and NSTEMI treatment physical
coronary revascularisation
CABG or PCI
STEMI
plaque rupture leading to amore complex or complete thrombotic occlusion of coronary lumen and infarction
Necrosis of myocardial tissue happens in a time-dependent manner following
coronary occlusion
PCI
percutaneous coronary intervention
angioplasty etc
Two main ways of treating STEMI
PCI
Firbinolysis
Fibrinolysis is performed when
PCI cannot be performed
Fibrinolysis
breaks down fibrin - therefore destroying plaque
STEMI treatment (secondary prevention)
stop smoking, diet, exercise
control BO, glycemic control
Aspirin
statin
beta blockers
ACE inhibitors
STEMI investigations
ECG
CXR (pulmonary oedema, widened mediastinum)
Blood (fasting glucose, U+E)
Cardiac Enzymes (troponin)
Echo (myocardial dysfunction)
Sudden cardiac death most patients have
ventricular fibrillation
ventricular tachycardia
Anti-platelet therapy for unstable angina and NSTEMI uses drug
should use an ADP receptor blocker like clopidogrel
and aspirin
ADP receptors blockers
a drug class of anti-platelet type
