Angina and ACS Flashcards
Stable Angina
CP for >2m precipitated by exertion or emotional distress that is not getting worse
3 types of ACS
- Unstable Angina
- NSTEMI
- STEMI
Difference between unstable angina and NSTEMI
NSTEMI= elevated cardiac enzymes
Modifiable risk factors for development of CAD
HHCD
- Hyperlipidemia
- HTN
- Cigarrette smoking
- Diabetes (bedus)
What are CKD, proteinuria, and chronic inflammatory states risk factors for?
CAD
Explain the steps of plaque formation (5 steps)
- Endothelial injury
- LDL and Macrophage deposition
- Foam cell formation
- smooth muscle recruitment into tunica intima
- deposition of ECM
Fibrous Cap with a Necrotic Center
3 outcomes of atherslerotic plaque deposition
- Aneurysm and Rupture
- Occlusion via Thrombus
- Stenosis
Clinical presentation of ACS
CP that radiates to neck, jaw, arms (angina pectoris) Dyspnea NV Diaphoresis Fatigue
What groups of people should you suspect atypical presentations of ACS in?
Elderly
Women
Wilford Brimley (Diabetics)
Diamond Forrester Criteria of CP
- Substernal CP
- Provoked by exertion/emotion
- Relieved by Nitro
Using the Diamond Forrester Criteria, define typical, atypical, and Non-Angina CP
Typical- all 3 components
Atypical- 2/3
Non-Anginal- <1
What would you see on ECG in stable angina, unstable angina, NSTEMI, and STEMI?
Stable= NORMAL Unstable/NSTEMI= ST depression/Inverted T wave STEMI= ST elevation with hyper acute T wave
Different stressors of a cardiac stress test
- Exercise
2. Pharmacology- Vasodilators or Dobutamine
3 testing modalities of a stress test
- Stress ECG
- ECHO
- Myocardial Perfusion Imaging (MPI)
If a person has abnormalities on ECG during a stress test, what is the next step of treatment?
Coronary Angiography
STEMI ECG criteria
ST elevation >2mm in continuous leads or new LBBB