Acute Coronary Syndrome (ACS) Flashcards
What conditions does ACS consist of? (2)
Unstable angina
MI
What are the common underlying pathology of ACS? (2)
Plaque rupture, thrombosis and coronary artery inflammation.
Rarely due to embolism, coronary spasm or vasculitis.
What are the main features of MI? (3)
Myocardial cell death, releasing cardiac troponin with ischaemia.
ST-segment elevation (STEMI) + non-segment elevation (NSTEMI) on 12 lead ECG
STEMI: complete obstruction, NSTEMI: incomplete obstruction.
What are the main features of unstable angina? (2)
Similar clinical presentation as NSTEMI without significant rise in cardiac troponin.
Classified based on ECG then cardiac troponin levels.
What are the non-modifiable risk factors of ACS? (4)
Age
Male
Family Hx
Ethnicity
What are the modifiable risk factors of ACS? (7)
Smoking
Diabetes
HPT
Dyslipidaemia
Obesity
Lack of exercise
Cocaine use
What are the symptoms of ACS? (2)
Acute chest discomfort > 15 mins or in past 12 hrs.
- Dull, central and/or crushing. Not relieved by rest. May radiate
Associated symptoms: Anxiety, Nausea, Pallor, Sweatiness, Dyspnoea, Palpitations.
What are the signs of ACS? (3)
Associated with haemodynamically instability (systolic BP < 90mmHg):
- Tachycardia + sweating = sympathetic activation
- Bradycardia, N+V = Vagal activation.
4th heart sound, low grade fever
Signs of HF (3rd heart sounds, increased JVP, basal crepitations)
What are the cardiac causes of chest pain?
What are the non-cardiac causes of chest pain?
What investigations are carried out to diagnose ACS?
What is the universal definition of MI?
Explain the initial management of suspected ACS.
What are main features of normal, NSTEMI, STEMI ECG?
Explain the early management of STEMI.
What are the main features of PPCI?
State the main features of Fibrolysis.
Explain the use of medications in managing ACS.
Explain the secondary prevention of ACS.
Explain the use of novel therapies in ACS.
What is usually covered as part of cardiac rehabilitation? (2)
What lifestyle advice is given to patients with ACS? (6)
Explain the early management of NSTEMI /Unstable Angina.
