Acute Coronary syndromes Flashcards
What is the underlying pathology for ACS?
Plaque rupture
Thrombosis
Inflammation
What does a plaque rupture in the artery lead to?
Thrombosis
Potential occlusion of the artery
What is an MI diagnosed?
Troponin levels (usually raised)
Presence of ischaemia symptoms
ECG (Q-waves, ST elevation)
Coronary angiogram (evidence of problem)
What are the main clinical presentations of an ACS?
Acute central chest pain (>20 mins) Nausea and dyspnoea Pallor, sweatiness Increased or decreased pulse and BP 4th heart sound Pansystolic murmur
Which ECG leads check the anterior segment of the heart?
V1-V4
Which coronary artery would be blocked in an inferior MI?
Right coronary artery
When is thrombolysis mainly indicated?
If MI, but not access to cath lab within 2 hours
What are the main contraindications to thrombolysis?
Stroke within 3 months
Prior intracranial haemorrhage
Active bleeding
Recent surgery
What treatment is suggested if NSTEMI?
Aspirin Clopidogrel LMW heparin IV nitrate Analgesia Beta- blockers Glycoprotein receptor inhibtors
How does aspirin work?
Potent inhibitor of platelet production
How does LMW heparin help in treatment?
Bleeding risk reduction
What are beta-blockers mainly used for?
Secondary prevention
