Acute Coronary Syndromes Flashcards
Acute coronary syndrome
the group of symptoms attributed to the obstruction of coronary arteries
examples of acute coronary syndrome (ACS)?
unstable angina
Non ST elevation myocardial infract (NSTEMI)
STEMI
What are the cause of ACS?
the rupture of atherosclerosis clot in arteries and subsequent formation of clot
What symptoms does partially occlusive clot result in?
The ECG of these symptoms
unstable angina
NSTEMI
ST segments depression and T wave inversion
What charge (+/-) serum biomarker used to diagnose unstable angina?
(-) serum biomarker
Why STEMI is more severe than NSTEMI?
How is the ECG different from normal ECG?
because ischemia is more severe & myocardial infarct is larger
ST segment elevation
What will atherosclerosis result in?
plague disrupture
endothelial cells dysfunction
What is the consequence of endothelial dysfunction?
vasodilation decreases
antithrombotic effect decreases
What charge (+/-) serum biomarkers used to diagnose NSTEMI?
When plague ruptures, what are the consequences?
intraplague hemorrhage
release of tissue factor
exposed collagen fibers
turbulence of blood flow
What will the exposure of collagen fibers & turbulence of blood flow cause?
platelet activation & aggregation
What does platelet activation & aggregation will result in?
plasma coagulation
vasoconstriction
What happen when tissue factors released?
plasma coagulation occurs
what does intraplague hemorrhage result in?
decrease vessel lumen diameter
What charge (+/-) serum biomarkers used to diagnose STEMI?
(+) serum
Coronary thrombosis is the combination of what symptoms?
decreased vessel lumen diameters
plasma coagulation
platelet aggregation
vasoconstriction
Where are the most common myocardial infarct?
Why?
sub-endocardial
because it has the highest pressure
it is perfused by blood vessels that can easily be compressed
The degree of myocardial infarcts depend on?
the mass of myocardium perfused by blood vessel
the magnitude and duration of impaired flow
oxygen demand of the affected tissue
adequacy of collateral vessels from neighboring non-occluded coronary branch
degree of tissue response that modifies the ischemic process
How does the myocardial infarct develop over time?
clearing of necrotic myocardium (yello softening)
deposit of collagent to form scar tissue (fibrosis)
What ability that myocardial infarct heart will lose?
lose the synchronous contraction of myocytes
diastolic dysfunction
When the heart lose its synchronous contraction of myocytes, what will happen?
systolic dysfunction = impaired ventricular contraction -> cardio output decrease
hypokinetic
akinetic
dyskinetic
decreased contractility
no contractility
outward contractility
What does diastolic dysfunction will cause?
reduction of ventricular compliance
higher filling pressure
severe venous engorgement
venous engorgement
distended neck veins
pericardial effusion & tamponade
What does it cause?
leak of blood into the space btw myocardium & pericardial sac
extra pressure on heart & thin atrium wall
Why we can use the serum biomarker to diagnose the myocardial infarct?
because macromolecules will leak from the necrotic tissues into the blood stream
What are the serum markers to diagnose MI?
cardiac troponin
creatine kinase
What does the drug clopidogrel do?
what drug does it have same effects as?
prevent stroke, heart attacks
aspirin
