Coronary Heart Disease Flashcards
Substernal chest pain radiating to the neck and arm with ST segment elevations > 1mm in > 2 contiguous leads on ECG and evidence of myocardial necrosis (cardiac markers in blood; troponin I or troponin T and elevated CK)
ST-Segment Elevation Myocardial Infarction (STEMI)
Q waves and ST elevation in leads I, AVL, and V2 to V6
Anterior wall infarction
Q waves and ST elevation in leads II, III, and AVF
Inferior wall infarction
ST depressions in leads I, AVL, and V5 to V6
Lateral wall infarction
Will likely show ST depressions and then elevations in V1 to V3
Posterior wall infarction
Appears at 4-8 hours, peaks 12-24 hours and lasts for 7-10 days
Troponin
Appears at 4-6 hours, peaks at 12-24 hours and lasts for 3-4 days
CK/CK-MB
Absolute contraindications for fibrinolytic use in STEMI
Prior intracranial hemorrhage (ICH)
Known structural cerebral vascular lesion.
Known malignant intracranial neoplasm.
Ischemic stroke within 3 months.
Suspected aortic dissection.
Active bleeding or bleeding diathesis (excluding menses)
GOLD STANDARD treatment best if within 3 hours (90 minutes) of sx onset
PCI (Percutaneous Coronary Intervention)
Patient with acute crushing chest pain with evidence of myocardial necrosis (cardiac markers in blood; troponin I or troponin T and elevated CK) without acute ST-segment elevation or Q waves
Non-ST-Segment Elevation MI (NSTEMI)
Chest pain or discomfort that most often occurs with activity or emotional stress relieved by rest
Stable angina
Chest pain or discomfort that most often occurs with activity or emotional stress. Previously stable and predictable symptoms of angina that are more frequent, increasing or present at rest
Unstable angina
Coronary artery vasospasms causing transient ST segment elevations, not associated with clot
Prinzmetal variant angina
