Acute coronary syndromes - case studies Flashcards
What is the tx pan for this pt?
initial/emergency: given DAPT and taken directly to cardiac cath lab for primary PCI
Maintenance/further treatment:
- hospitalised for 48-72 hours
- started in DAPT - aspirin and ticagrelor
- high dose statin - atorvastatin 80 OD
- beta blocker - bisoprolol
- ACE inhibitor - ramipril
- request echo to assess LV function
What does this ECG show?
ST elevation
after S (the dip) it should be flat to the T wave
It should be on the isoelectric line before T wave
In PCI, what does the catheter drip into the artery?
dye - can see where the blockage is
after the surgery - die will flow through artery
After a STEMI, how long is the pt in hospital?
48-72 hours
Why prescribe high dose statin after PCI?
Prevent further MI regardless of cholesterol level
Why prescribe ACE and beta-blocker after PCI?
Treat damage to myocardium from infarction
prevent admission with heart failure
Why request echo to assess LV function after PCI?
Primary determinant of prognosis after MI
Is this pt STEMI or NSTEMI?
STEMI
What is GTN?
vasodilator
Why is this case a NSTEMI?
Chest pain
Normal ECG
raised troponin
Why is this case an STEMI?
chest pain
ST elevation on ECG
rise in troponin
What is the normal troponin level for a women?
16
What is the treatment for case 2?
almost same tx plan as case study 1
however, she gets all the medication first, within a day or 2 go to the cath lab for a procedure
With NSTEMI, is the artery completely blocked?
no, some blood movement by thrombus
