CV 18 Flashcards
What is ACS
syndrome (set of signs and symptoms) indicative of inadequate coronary perfusion and ischemia
ACS is pro what??
pro thrombotic and pro inflammatory
pathophysiology of ACS
disruption of atherlosclorotic plaque in the coronary arteries causing platelet activation and formation of coronary thrombus
what are the consequences of an ACS
death - SDC
fatal arrhythmias (VF/VT)
anoxic brain damage
heart failure
valvular dysfunction
clinical presentation of ACS
chest pain, pressure, tightness, sweating (diaphoresis), SOB
how do women, elderly, and DM pts present
pain in arm, SOB, indigestion, N/V, weakness/fatigue
what are initial routine measures?
MONA
when is morphine used
if nitroglycerin is ineffective!
what does morphine do
symptomatic relief, decreases pain anxiety and pulmonary edema
ASA efficacy and toxicity
mortality reduction, bleeding, thrombocytopenia
nitroglycerin
reduction in pain,, hypotension, headache
avoid in SBP <90mmHG, and in recent 1-2 days use of phosphodiesterase 5 inhibitors
morphine
reduction in chest pain, avoid in suspected RV infarction, hypotension, rash,
risk strat
unstable angina (no ecg changes) = low risk
NSTEMI (moderate risk)
STEMI (high risk)
what does troponin indicate
myocardial cell death, higher number leads to HF and puts you at risk for arrythmias
three ways of revascularization
PCI, CABG, medical therapy
