Coronary Artery Disease Flashcards
What is the chief and only symptom of MI (myocardial infarction)
Angina
What lab tests are elevated in MI?
Troponin elevation
To diagnose MI, we need a change in which cardiac biomarker?
High sensitivity cardiac troponin
Definition of unstable angina?
Increase in frequency, duration, and severity of
What is Type 1 MI?
Atherosclerotic plaque that ruptures and causes occlusion of coronary artery
What is Type 2 MI?
Imbalance between myocardial oxygen demand and supply
In type 2 MI, can you name causes of the reduced myocardial perfusion?
Hypotension, anemia, respiratory failure
In Type 2 MI, name causes of increased myocardial oxygen demand?
Sustained tachyarrythmia and hypertension
The high risk clinical feature of MI is?
Hypotension
What is the treatment of choice for STEMI?
PPCI, mechanical reperfusion
If it’s too late for a PPCI, what do we do?
Fibrinolytic therapy.
What are the contraindications to fibrinolytic therapy?
An ischemic stroke in the last 6 months, recent trauma, GIT bleeding within a month, or a known bleeding disorder
What is the therapy post STEMI treatment?
DAPT + P2 Y12 inhibitor for 12 months (dual anti platelet therapy)
How does the DAPT therapy start?
We prescribe loading doses of both Aspirin and Clopidogrel
What is the course of DAPT therapy?
75mg daily of both aspirin and clopidogrel
Additional drug therapies?
Beta blockers for ACS patients and ofc Lipid lowering therapy for the LDLs’
What are some complications of STEMI?
Sudden death, HF, pulmonary edema
In the management of NSTEMI, what’s the aim of treatment?
Rapid relief of the acute ischemia
What is important to do early on in NSTEMI management?
TIMI and GRACE risk scoring
In very high risk NSTEMI, what do we do quickly?
Coronary angiography within 2 hours
A GRACE score of what determines high risk NSTEMI?
Greater than 140
