CAD/ACS Flashcards
What are the indications for a CABG?
- LAD is affected
- 3 vessel disease
- 2 vessel disease if a diabetic
- Symptomatic despite maximal therapy
What is the physiology behind angina?
Oxygen supply cannot meet the demand of the heart!
Describe how stable angina will present?
Exertion/stress
–> Chest pain
–> Relieved by rest or nitrates
Describe how stable angina will present?
Exertion/stress
–> Chest pain
–> Relieved by rest or nitrates
Can you have other symptoms such as diaphoresis, SOB, dizziness, N/V with stable angina?
YES
What will the results of the EKG and Cardiac Enzymes be with Stable Angina? Unstable Angina?
NEGATIVE
What defines Unstable Angina?
- Chest pain now occurring at rest
- Chest pain that is worsening in nature, such that is occurs easier, lasts longer, etc.
What defines Unstable Angina?
- Chest pain now occurring at rest
- Chest pain that is worsening in nature, such that it occurs easier, lasts longer, etc.
Besides EKG and Cardiac Enzymes, what are 2 other tests that can be done to assess coronary vasculature?
- Stress testing
- Coronary angiography
With stress testing is is either with exertion or?
Medication such as Dobutamine
With stress testing with medications, how does that work?
Diseased vessels are already maximally dilated so change will be seen in the non-diseased vessels
Prior to a stress test, what medications should be held for at least 48 hours? (3)
Beta blockers
CCBs
Nitrates
What is the mainstay of treatment for Stable Angina?
Aspirin
Beta blockers
+/- Nitroglycerin
What causes Prinzmetal Angina?
Coronary vessel vasospasm
How will Prinzmetal Angina present? In who?
Young women with chest pain that occurs at rest and often in the morning
How will Prinzmetal Angina present? In who?
Young women with chest pain that occurs at rest and often in the morning
What is the best treatment for Prinzmetal Angina?
CCBs!
Results of the EKG and Cardiac Enzymes for a NSTEMI?
EKG = normal
Cardiac enzymes = (+)
What is the full treatment for ACS?
MONA-B(ASH)
- Morphine
- O2
- Nitrates
- Aspirin + other Anti-platelets
- Beta blocker
- ACEi
- Statin
- Heparin
What is the full treatment for ACS?
MONA-BASH
- Morphine
- O2
- Nitrate
- Aspirin + Antiplatelet therapies
- Beta-blocker
- ACEi
- Statin
- Heparin