Acute Coronary Syndromes 2

Question 1

How can ischaemia develop to infarction?

Answer 1

Atheroma in vessels causes aggregation (combining) of platelets causing a thrombosis (clott) which blocks the vessel

Clott can also travel down bloodstream and block the vessel further down

Question 2

Blockage of the femoral and popliteal arteries causes…

Answer 2

Infarction of Limbs

Question 3

Blockage of the carotid arteries causes…

Answer 3

Infarction of brain

Question 4

Blockage of the coronary arteries causes…

Answer 4

Infarction of heart

Question 5

What are the signs of myocardial infarction occuring?

Answer 5

• Pain, nausea, pale, sweaty (Autonomic NS activated)
• ‘going to die’
• Sometimes no symptoms or signs, SILENT MI’s

Question 6

Myocardial Infarction diagnosis investigations include:

Answer 6

• History
• ECG (either NSTEMI or STEMI)
• ELEVATED Troponin levels

Question 7

What happens to a patient if MI occurs?

Answer 7

• Get patient to hospital alive
• Acute angioplasty or stenting
• Thrombolysis if suitable
• Drug treatment to reduce tissue damage
• Prevent recurrence/complications (secondary prevention)

Question 8

What is thrombolysis?

Answer 8

A procedure to dissolve blood clots (a thrombus)

Question 9

When would thrombolysis be done?

Answer 9

If angioplasty & stent isnt possible or if patient has been delayed admission

Question 10

What are complications of myocardial infarction?

Answer 10

• Death
• Post MI arrhythmias
• Heart failure
• Ventricular HYPOfunction
• DVT

Question 11

What are long term medical management options for MI?

Answer 11

Prevent next MI:

• aspirin and risk modification
• B blocker
• ACE inhibitor

Treat complications:

• Heart failure
• Arrhythmias