Cardiac Causes Of Cardiac Arrest Flashcards
What is ACS
A group of clinical conditions which present with chest pain / discomfort resulting from ischaemia
Run through algorithm for ACS
What is the usual cause of angina?
Usually myocardial ischaemia, mostly caused by obstructive CAD
What is unstable angina?
Unprovoked or becoming more common with less and less activity
An ECG with angina can show?
Do you need to wait for troponin with stemi?
No
What are high risk rhythm that may develop with stemi
VT, VF, or dead rhythm
Changes in v1-v4 are what and which artery?
Anterior infarction with the LCA and extension into v5 & v6 is anterolateral
What leads are inferior infarction seen?
What artery?
ii, iii, avf
RCA
Lateral infarction, what leads and what artery?
v5, 6, i, avl
Circumflex and LCA (diagnol branch)
What is the immediate tx of all ACS?
12 lead ECG
Aspirin 300mg
O2 94-98%
Gtn (unless shocked)
Analgesics - IV opiate
If within 12 hrs of sx onset of stemi, what to do immediately?
PCI
Or
Fibrinolytic
Beyond 12 hrs, it can be done if signs of continuing ischaemia
Call to Balloon time?
< 60 to 90 minutes
What meds should be given aside from aspirin with ppci?
Anticoagulant like clopidogrel, ticagrelor, prasugrel
In the lab, heparin and maybe glycoprotein in high risk patients
What is the algo for reperfusion of stemi?
Contraindications for fibrinolytic tx
What sort of rhythm can show reperfusion?
Accelerated Idioventricular
If fibrinolytic fails or 12 lead doesn’t show at elevation resolving by more than 50%, then what?
Ppci is needed
If fibrinolytic fails or 12 lead doesn’t show at elevation resolving by more than 50%, then what?
Ppci is needed
Nstemi tx?
Heparin, aspirin 300mg loading then 75 mg daily, adp blocker like clopidogrel, beta blocker / diltazem to reduce myocardial oxygen demand, nitrates, maybe ace i
To preserve left ventricular function after ami, what drug
Ace inhibitor (reduces remodel) and beta blocker (size of infarction)
