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Pharmacology > Acute coronary syndromes > Flashcards

Acute coronary syndromes Flashcards

1
Q

Definition of ischemia

A

A condition in which blood flow is restricted or reduced in certain parts the body. Meaning o2 is flow is reduced

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2
Q

What is cardiac ischemia

A

The reduction in the flow of o2 to the cardiac muscles

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3
Q

How would u calculate the heart rate of someone with a regular heart rate using an ECG

A

Count the number of squares in one R-R interval, then divide 300 by this number.
R-R interval = from one QRS complex to another

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4
Q

How would u calculate the heart rate of someone without a regular heart rate using an ECG

A

Count the number of qrs complexes in a full rhythm strip then times that by 6.
One rhythm strip is 10 seconds or 50 squares

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5
Q

What are thre two types of cardiac arrhythmia

A

1) regularly irregular, there is a pattern to the irregularity of the heart rate
2) irregularly irregular, there is no pattern to the irregular heart rate

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6
Q

What is a p wave on an ECG

A

It shows atrial depolarisation,

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7
Q

What is the normal duration of a p wave

A

120-200 ms and that is 3-5 small squares

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8
Q

What does a long PR interval suggest

A

atrioventricular delay/ block

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9
Q

What is the QRS complex

A

It shows ventricular depolarisation

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10
Q

What is the st segment

A

It shows the amount of time between ventricular depolarisation and ventricular repolarisation

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11
Q

What are the types of acute cardiac ischaemic states

A

1) unstable angina
2) NSTEMI, non ST segment elevation myocardial infarction
3) STEMI, ST segment elevated myocardial infarction

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12
Q

What is NSTEMI

A

Non st segment elevated myocardial infarction, this is a heart attack where the ST segment of the ECG is elevated. It is caused by partial occlusion of the coronary arteries of plaque, then when a plaque ruptures ( plaque breaks) this cause caused blood clots to form resulting in thrombosis.

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13
Q

What is unstable angina

A

This is where plaque/ thrombosis in coronary arteries cause reduced blood flow.
- However, unlike normal angina, the frequency and the severity of the chest pain is higher
- the chest pain also happens at rest

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14
Q

What is atherosclerosis

A

Thickening or hardening of the arteries caused by a build up of plaque ( cholesterol)

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15
Q

What is STEMI

A

St elevated myocardial infarction, a heart attack where the st segment on the ECG is elevated, this is caused by a total occlusion of the coronary arteries, unstable plaque rupture occurs causing thrombosis

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16
Q

What is atherosclerosis CAD

A

atherosclerosis In the coronary arteries which reduces the flow of oxygenated blood going to the heart muscles.

17
Q

What is thrombosis

A

A blood clot in blood vessels that reduces the flow of blood.

18
Q

What is acute myocardial infarction

A

When the muscles of the heart die caused by sustained myocardial ischemia

19
Q

How long does it take for a cardiac tissue to die after complete occultation

A

20-40 minutes
And severe necrosis occurs after 2-3 hours

20
Q

What are clinical feature of acute MI

A
  • Chest pain for more than 20 minutes
  • often associated with nausea, sweating, dyspnea (difficulty breathing)
    ECG changes
  • inverted t wave
  • st segment elevation
  • q wave development
    Enzymatic changes
  • heart releases troponin
    Serum levels increase within 3- 12 hours hours and peak within 24 - 48 hours and return to baseline level in 5-14 days
21
Q

What is the criteria for a acute MI diagnosis

A
  • ischemia symptoms
  • changes to their ECG, st segment/ t wave changes
  • rise/fall of serum biomarkers relative to the time of the MI episode
  • loss of myocardium on imaging
22
Q

What are non modifiable risk factors of acute MI

A
  • age
  • gender
  • family history of IHD
23
Q

What are modifiable risks factors of acute MI

A
  • drinking
  • smoking
  • hypertension
  • hyperlipidemia
  • obesity
  • obesity
  • sedentary lifestyle
24
Q

What is myocardial salvage in the acute phase.

A
  • reduce myocardial oxygen demand via
    • beta blockers
    • nitrates
  • restore myocardial blood supply through reperfusion
25
Q

What is secondary MI treatment

A

A combination of pharmacological and non pharmacological treatment

26
Q

What is are the secondary treatment of MI

A

Pharmacological treatments
S - statin
A - ACE inhibitor
A - dual anti-platelet
B - beta blocker
GTN - glycerine trinitrate, a vasodilator
Non pharmacological treatment:
Cardiac therapy

27
Q

What lifestyle changes occur after MI

A
  • diet change
  • alcohol consumption
  • smoking cessation
  • weight management

Pharmacology (17 decks)

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