Exam 1 - Acute Coronary Syndrome Flashcards
1
Q
unstable angina
A
new or changing chest pain caused by ischemia
2
Q
NSTEMI
A
non-ST segment elevation myocardial infarction
3
Q
STEMI
A
ST segment elevation myocardial infarction
- life threatening emergency
4
Q
variant/vasospastic angina
A
prinzmetal angina
5
Q
variant/vasospastic angina cause
A
- coronary artery spasm
- endothelial dysfunction
6
Q
characteristic of variant/vasospastic angina
A
- CAD may or may not be present
- onset timing: rest, minimal exertion, night
- specific ECG changes: elevated ST segment
- treatment: nitrates - relaxes spasm
7
Q
unstable plaque
A
- lipid core is large
- inflammation is active
- smooth muscle cells proliferate into intima
8
Q
unstable angina
A
- chest pain occurring for the first time (myocardial ischemia)
- chest pain more severe than usual with chronic angina
- emergency situation
9
Q
what you see with unstable angina
A
- ruptured plaque + thrombus
- no infarction because occlusion is partial or thrombus dissolves
- transient ECG changes
- no cardiac enzymes are elevated
10
Q
ACS vs stable angina
A
- severity and duration
- relief with nitrates
- additional pain descriptors
- accompanying symptoms
11
Q
signs and symptoms of myocardial infarction (MI)
A
- diaphoresis
- dyspnea
- extreme anxiety
- Levine’s sign (fist to chest)
- pallor
- retrosternal crushing chest pain that radiates to shoulder, arm, jaw, or back
- weak pulses
12
Q
what do you see with an acute MI
A
- ruptured plaque + thrombus
- there is an infarction because blood flow disruption is prolonged OR blood flow disruption is total
- ECG changes
- cardiac enzymes elevated
13
Q
acute MI
A
- ACS with prolonged ischemia without recovery
- myocardial cells suffer irreversible ischemic necrosis
- classified by ECG findings
14
Q
ischemia
A
- oxygen supply is not meeting the hearts metabolic demands
- full recovery is possible
15
Q
infarction
A
- irreversible tissue death
- beyond hope of recovery but can stop from increasing
16
Q
injury
A
- some recovery possible
- can still perfuse and restore to become viable
- not dead yet
17
Q
what factors influence extent of damage with acute MI
A
- location or level of occlusion in the coronary artery
- length of time that the coronary artery has been occluded
- heart’s availability of collateral circulation
18
Q
left anterior descending (LAD) artery
A
- supplies the left ventricle
- most commonly involved in myocardial infarction
- “widowmaker”
