acute coronary syndrome Flashcards
umbrella term that includes?
STEMI
NSTEMI
unstable angina
is ACS relieved by GTN?
no
it must last longer than ?
20 mins
diagnosis of ACS?
raised troponin with ECG changes
3 main changes on ECG?
ST elevation in 2 or more leads
new LBBB
T wave inversion
ST elevation in I, avl, v5 and v6
lateral (circumflex)
II,III and aVF is a ? infarction. which artery is affected?
inferior
right coronary
st elevation in v1-v4, which artery?
anterior
Left anterior descending
v1-v6 and avl and i
anterolateral
aim to carry out PCI within?
90 minutes (if presenting within 12 hours of symptom onset)
if they present after 12 hours, what do you do?
still consider revascularization or just continue with medical management
what are patients given for secondary prevention ?
beta blockers reduce mortality
ace inhibitors to prevent cardiac remodelling
statin
aspirin 75mg
clopidogrel or ticagrelor for up to one year
blood pressure control
pericarditis up to 6 weeks post MI
dresslers syndrome
raised troponin and no ST elevation ?
NSTEMI
in NSTEMI, although there is no st elevation, what will the ECG most likely show?
signs of long term ischaemia or previous MI
is an NSTEMI as worrying as STEMI?
in general does not need to be treated as urgently
signs of long term ischaemia on ECG?
ST depression
T wave inversion
following confirmation of an NSTEMI how do you treat it medically?
beta blockers and factor 10a inhibitor (fundaparinex)
treatment of NSTEMI?
BB and LMWH and decide if they need PCI
what is unstable angina ?
history of angina that is becoming more frequent and severe
occuring on minimal exertion or at rest
increasingly poor response to GTN
diagnosis of unstable angina ?
normal troponins and no ST elevation
management of unstable angina ?
same as per NSTEMI
b blocker and LMWH
would PCI be carried out in unstable angina?
maybe, depends on patient
secondary prevention of unstable angina?
same as STEMI/NSTEMI
