CVD - ACUTE CORONARY SYNDROMES

Question 1

What would you do when managing a STEMI/NSTEMI?

Answer 1

Single dose aspirin 300mg - limit clot size and allow blood flow

Oxygen - ease breathing

GTN spray or SL tablet - vasodilator to ease blood flow

Morphine - relieve pain and anxiety

Metoclopramide - relieve nausea from morphine

LMWH - anticoagulant to prevent clot growth

Question 2

What is the long term management for NSTEMI/STEMI?

Answer 2

Dual antiplatelet for up to 12 months - aspirin 300mg + ticagrelor 180mg OR clopidogrel (then aspirin and clopidogrel)

ACE - continue indefinitely

BB - cardioselective one (metoprolol, bisoprolol, atenolol). Review after 12 months

Statin - high dose atorvastatin 80

Question 3

How long is clopidogrel given for in a STEMI?

Answer 3

4 weeks

Question 4

How long is clopidogrel given for in an NSTEMI/unstable angina?

Answer 4

12 months

Question 5

What would you do in a medical emergency of unstable angina/NSTEMI?

Answer 5

Dispersible/chewable aspirin 300mg stat

GTN PRN sublingually or spray

You would also do this with a STEMI but add on IV morphine + metoclopramide

Question 6

What would you do in a cardiac arrest situation?

Answer 6

• Resuscitation - 30 compressions: 2 breaths
• IV adrenaline
• IV amiodarone - if ventricular fibrillation present