acute coronary syndrome

Question 1

umbrella term that includes?

Answer 1

STEMI
NSTEMI
unstable angina

Question 2

is ACS relieved by GTN?

Answer 2

no

Question 3

it must last longer than ?

Answer 3

20 mins

Question 4

diagnosis of ACS?

Answer 4

raised troponin with ECG changes

Question 5

3 main changes on ECG?

Answer 5

ST elevation in 2 or more leads
new LBBB
T wave inversion

Question 6

ST elevation in I, avl, v5 and v6

Answer 6

lateral (circumflex)

Question 7

II,III and aVF is a ? infarction. which artery is affected?

Answer 7

inferior

right coronary

Question 8

st elevation in v1-v4, which artery?

Answer 8

anterior

Left anterior descending

Question 9

v1-v6 and avl and i

Answer 9

anterolateral

Question 10

aim to carry out PCI within?

Answer 10

90 minutes (if presenting within 12 hours of symptom onset)

Question 11

if they present after 12 hours, what do you do?

Answer 11

still consider revascularization or just continue with medical management

Question 12

what are patients given for secondary prevention ?

Answer 12

beta blockers reduce mortality
ace inhibitors to prevent cardiac remodelling
statin
aspirin 75mg
clopidogrel or ticagrelor for up to one year
blood pressure control

Question 13

pericarditis up to 6 weeks post MI

Answer 13

dresslers syndrome

Question 14

raised troponin and no ST elevation ?

Answer 14

NSTEMI

Question 15

in NSTEMI, although there is no st elevation, what will the ECG most likely show?

Answer 15

signs of long term ischaemia or previous MI

Question 16

is an NSTEMI as worrying as STEMI?

Answer 16

in general does not need to be treated as urgently

Question 17

signs of long term ischaemia on ECG?

Answer 17

ST depression

T wave inversion

Question 18

following confirmation of an NSTEMI how do you treat it medically?

Answer 18

beta blockers and factor 10a inhibitor (fundaparinex)

Question 19

treatment of NSTEMI?

Answer 19

BB and LMWH and decide if they need PCI

Question 20

what is unstable angina ?

Answer 20

history of angina that is becoming more frequent and severe
occuring on minimal exertion or at rest
increasingly poor response to GTN

Question 21

diagnosis of unstable angina ?

Answer 21

normal troponins and no ST elevation

Question 22

management of unstable angina ?

Answer 22

same as per NSTEMI

b blocker and LMWH

Question 23

would PCI be carried out in unstable angina?

Answer 23

maybe, depends on patient

Question 24

secondary prevention of unstable angina?

Answer 24

same as STEMI/NSTEMI