Acute Coronary Syndrome + Shock Flashcards
1
Q
Acute Coronary Syndrome (ACS) RF
A
Age, tobacco, hyperlip, DM, HTN, obesity, fam hx
2
Q
ACS Presentation
A
- CP or pressure
- Levine’s sign (clutching chest)
- Radiation to arm, neck, jaw
- Heartburn
- SOB
- Diaphoresis
- NV
- Syncope
- Fatigue
3
Q
ACS physical exam
A
- BP, HR and rhythm
- SPO2
- Distress? Anxious?
- JVD?
- Diaphoresis?
- Heart sounds
- Rales?
4
Q
ACS tests/labs to perform
A
- EKG
- Troponin
- CPK (muscle damage)
- CPK-MB (heart muscle damage)
- CXR (heart size, fluid in lungs)
- CBC
- CMP
5
Q
ACS tx
A
- MONA
- If nitro causes hypoTN, MI is on right heart
- Morphine: pt in pain has high HR, requires more O2 (want to decrease HR and O2 demand)
6
Q
Unstable angina
A
Plaque obstructing flow, but flow is still happening
7
Q
Unstable angina presentation
A
Sx at rest (vs stable angina, sx w/ exertion)
8
Q
Unstable angina test/lab results
A
- Biomarkers are NOT elevated
- Normal EKG
9
Q
Unstable angina tx
A
Observe for >12 hrs:
- If no pain or neg f/u studies –> d/c
- If + stress test –> ACS, admit
- If pain recurs or + f/u studies –> ACS, admit
10
Q
STEMI
A
Acute clogged pipe, full occlusion, no O2 to heart
11
Q
STEMI test/lab results
A
- EKG: diffuse ST elevations
- Elevated biomarkers
12
Q
STEMI tx
A
- REFER to cardiology for cath
- Cardiac rehab after d/c
13
Q
NSTEMI
A
Not fully occluded, but bloodflow is blocked enough to produce sx
14
Q
NSTEMI test/lab results
A
- EKG: no ST changes
- Elevated biomarkers
15
Q
NSTEMI tx
A
- Aspirin + Plavix + Statin + ACEI
- Cardiac rehab after d/c
