Cardiology ACS Flashcards
What do raised troponin indicate and what is unique about cardiac troponin
Raised troponin is usally indicitive of a Acute Infarction of cardiac tissue.
Troponin 1 & Troponin T are both unique to cardiac tissue and are most senstive to damage
Any elevation of these enzymes can be diagonostic of ethier a AMI or can be caused by chronic conditions such as heart flaiure
What does the Right Coronary (RCA) artery supply
This leads into the Posterior decending artery.
it feeds the INFERPOSTERIOR aspect of the apex, RIGHT VENTRICLE & 1/3 of the septum.
It also usually feeds the SA node, 1/3 of the intraventricular septum, AV node and the posterior papillary muscle
Does everyones RCA supply the 1/3 of the septum
No depending on the person some being have LCA dominance and that is where the left circumflex artery supplys that part of the septum. Some people have co-dominance where both arteries supply the septum. This can possible change the reading of our STEMI’s
What coronary arteries supply which areas of the heart
What type of damage correclates to that we see on the ECG
T wave Ischemia characteristics
What is the criteria for meeting injury/infarction pre hospitally
What is the criteria for INFARCTION when it comes to Q waves
How do we look at the reciprocal changes for a STEMI
Reciprocal changes are used to AID the diagnosis of a STEMI and it is not enough to diagnose off of
What is V4R
This is where you take the V4 electrode and place it on the right hand side of the pts body
Why and when would you take a V4R?
The general rule of thimb is if there is ST elevation in out inferior leads and there is greater elevation in lead 3 other than lead 2 V4R can be used.
What benefit does taking V4R give us
This allows us to look at a different side of the heart and see if there is right ventricluar involvment. As a result these pts will be more preload dependent and could benefit alot better from fluids
What is a broad list for STEMI mimics
What are some interventions and treamtent paths ways for ACS
What should we do for a pt with cardiogenic shock
Obtain large bore access
Administer 500ml if fluid provided CPO is not present and titrate effectivley
Call back up or clinical to administer an adrenaline infusion 1:1000000
