Cardiovascular

Question 1

What is ACS?

Answer 1

Acute coronary syndrome encompasses unstable angina and evolving MI

Question 2

What are causes of ACS?

Answer 2

plaque rupture, thrombosis, inflammation, emboli, coronary spasm

Question 3

What are the risk factors for ACS?

Answer 3

age, M>F, family history of IHD, smoking, DM, hypertension, hyperlipidaemia, obesity

Question 4

What are the symptoms of ACS?

Answer 4

acute central crushing chest pain >20mins, nausea, sweating, dyspnoea, epigastric pain, vomiting

Question 5

What is a silent MI?

Answer 5

In diabetics and elderly, can have ‘silent MI’ with no chest pain but present with syncope, epigastric pain and vomiting

Question 6

What are the signs of ACS?

Answer 6

distress, pallor, pulse fast/slow, raised/lowered BP, 4th heart sound

Question 7

What investigations would you perform if you suspected for ACS?

Answer 7

ECG
CXR (cardiomegaly, pulmonary oedema)
Bloods: FBC, U&E, glucose, lipids, BNP
cardiac enzymes

Question 8

What would and ECG show for STEMI, NSTEMI and unstable angina?

Answer 8

STEMI: ST elevation - tall T waves
NSTEMI: T wave inversion - ST depression
unstable angina: T wave inversion - ST depression