Acute coronary syndrome Flashcards
What usually causes ACS?
thrombus from an atherosclerotic plaque blocking a coronary artery
when a thrombus forms in a fast flowing artery what is the main constituent?
platelets
what arteries does the Left coronary artery become?
circumflex and left anterior descending
What areas does the right coronary artery supply?
right atrium and ventricle
inferior aspect left ventricle
posterior septal area
where does the circumflex artery supply?
left atrium
posterior aspect left ventricle
LAD supplies?
anterior aspect left ventricle and septum
Three types of ACS
non-stable angina
NSTEMI
STEMI
Diagnosis - first thing to do and findings
ECG
ST elevation or new left bundle branch block = STEMI
No ST elevation = troponin
troponin levels
raised and/or ST depression/t wave inversion = NSTEMI
no raised = unstable angina or MSK pain
Symptoms
nausea and vomiting sweaty and clamminess feeling of impending doom SOB palpitations pain radiate to jaw or arms
how long should symptoms last for MI?
atleast 20 mins - if not consider unstable angina
silent MI - who to watch out for?
diabetics
Heart area and artery
- anterolateral
- anterior
- lateral
- inferior
- Left coronary artery
- LAD
- circumflex
- right coronary artery
What are troponins?
proteins found in cardiac muscle
Non ACS causes of raised troponin
chronic renal failure sepsis myocarditis aortic dissection PE