Acute Coronary Syndrome Flashcards
What does Acute Coronary Syndrome include?
Stable Angina
NSTEMI
STEMI
What defines a STEMI:
Pathological:
Investigative:
What defines a STEMI:
Pathological: Complete Coronary Occlusion = Severe
Investigative: ST Elevation
What defines a NSTEMI:
Pathological:
Investigative:
What defines a NSTEMI:
Pathological: Partial Coronary Occlusion = Minor
Investigative: No ST Elevation
Non-modifiable Risk Factors of Acute Coronary Syndrome:
A:
G:
F:
Non-modifiable Risk Factors of Acute Coronary Syndrome:
A: Age
G: Gender/Sex
F: Family History
Modifiable Risk Factors of Acute Coronary Syndrome: D: O: S: H: H:
Modifiable Risk Factors of Acute Coronary Syndrome: D: Diabetes O: Obesity S: Smoking H: Hypertension H: Hyperlipidaemia
Acute Coronary Syndrome: dy/dx Diagnosis
APM
APG
Acute Coronary Syndrome: dy/dx Diagnosis
Angina, Pericarditis, Myocarditis
Aortic Dissection, Pulmonary Embolism, Gord
Acute Coronary Syndrome Symptoms: ACCP-R P B/D S N D Note:
Acute Coronary Syndrome Symptoms: Acute Central Chest Pain - Radiates to arm, neck, jaw Palpitations Breathlessness/Dyspnoea Sweating Nausea Dizziness Note: Elderly/Diabetic/Female, may have ACS without chest pain
ACS Signs: PARR HFM4
P
A
R
R
HF
M
4
ACS Signs: PARR HFM4 Pallor Anxiety Raised/Reduced Pulse Raised/Reduced BP
Heart Failure
Murmur (Pansystolic)
4th Heart Sound
ACS Investigations: BECC B E C C
ACS Investigations: BECC Blood: FBC, U & E, Glu, Lipids ECG Chest X-Ray Cardiac Enzymes: Troponin, Myoglobin, Creatine Kinase (CK-MM, CK-BB, CK-MB)
Acute Coronary Syndrome Immediate Intervention:
MOAN: Morphine (Opioids/Analgesics) Oxygen if < 93% Aspirin 300mg orally + Clopidogrel Nitrate (Nitroglycerate - GNT spray/tablet)
Acute Coronary Syndrome Treatment Types: M O A N - P C T MRFA
Acute Coronary Syndrome Treatment Types:
Morphine (Opioids)
Oxygen (acute)
ACE-Inhibitors
Anti-Platelet: Aspirin, Clopidogrel, Prasugrel, Ticagrelor
Nitrates - GTN
-
PCI (1st)
CABG (if PCI fails)
T (2nd in 4.5hrs) (anti-Thrombotics): Heparin, LmwH, Fondaparinux,
MRFA: Modifiable Risk Factor Adjustment: Smoking, Weight, Diet, Diabetes, Hypertension, Hyperlipidaemia.
Acute Coronary Syndrome Treatment Types: for STEMI BB A PA AP-C
Acute Coronary Syndrome Treatment Types: for STEMI
BB: Beta Blockers
A: Angiotensin Converting Enzyme Inhibitors
PA: Primary Angioplasty
AP-C: Antiplatelet- Clopidogrel
Acute Coronary Syndrome Treatment Types: for NSTEMI BB AT AP GpII/IIIa
Acute Coronary Syndrome Treatment Types: for NSTEMI BB: Beta Blockers AT: Anti-Thrombotics: LmwH, Fondaparinux AP: Anti-Platelet: Aspirin, Clopidogrel GpII/IIIa Antagonist
Monitoring & Ongoing Management of ACS Patient: BED-PAB BR E D P A B
Monitoring & Ongoing Management of ACS Patient: BED-PAB Bed Rest ECG Daily examination - Heart, Lungs, Legs Prophylaxis - thromboembolism Aspirin Beta Blockers