Cardio-ACS

Question 1

Describe Undtable angina Vs nstemi

Answer 1

Nstemi is unstable angina with elevated cardiac biomarkers(ck mb and Troponin)

Nstemi is acute myocardial ischaemia severe enough to cause detectable quantities of myocardial injury biomarkers but without st segment elevations on ecg

Question 2

What is the timi score and describe it

Answer 2

Thrombolysis in myocardial ischarmia

Estimates risk of mortality in MI or the need for urgent revascularization in patients with nstemi-acs

Age > 65
>3 CAD risk factors(dm htn smoke hypercholesterolemia)
Known CAD (>50% stenosis)
>= 2 episodes of severe angina in last 24 hours
Asa use in past 7 days
St deviation >.5mm
Elevated cardiac biomarkers

Each value 1

0-1 low risk and favours ischaemia guided strategy
>=2 non low risk and favors invasive surgery

Question 3

Antithombotic therapy for nstemi

Answer 3

Aspirin + clopidogrel and LMWH or factor Xa inhibitor

Unfractionated heparin is mainstay of therapy.. low molecular weight heparin(enoxaparin) had been shown to be superior