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CVS > Investigationan And Management Of Patiens With Acute Coronary Syndrome > Flashcards

Investigationan And Management Of Patiens With Acute Coronary Syndrome Flashcards

1
Q

What is an acute coronary syndrome?

A

When a coronary artery thickens and the atherosclerotic plaque ruptures releasing thrombogenic material leading to thrombus formation

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2
Q

If a patient does not have ST-segment elevation how can you tell they have had a myocardial infarction?

A

Retro sternal chest pain radiating the jaw and/or shoulder
Elevated troponin
Pathological Q waves
Intracoronary thrombus on angioplasty

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3
Q

What is a Type 1 Myocardial Infarction?

A

Atherosclerotic plaque ruptures which leads to an intraluminal thrombus forming leading to myocardial necrosis

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4
Q

What is a Type 2 Myocardial Infarction?

A

When an MI occurs as a result of something other than a coronary plaques instability

Due to supply and demand mismatch

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5
Q

If Jugular Vein Pressure is increased what may this indicate?

A

Right heart failure

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6
Q

What are the 3 main coronary arteries?

A

Right coronary artery
Left coronary artery:
2 branches
-Left Anterior Descending
-Circumflex

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7
Q

What does the right coronary artery supply?

A

Supplies SAN and AVN
RA + RV

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8
Q

If the right coronary artery gets occluded what happens to the the heart rate?

A

Reduces due to the right coronary artery supplying the SAN and AVN

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9
Q

If leads II, III and aVF are affected (ST elevation or depression) in an ECG what wall is this looking at of the heart?

What coronary artery is therefore affected?

A

Inferior wall
Right coronary artery

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10
Q

If leads V1, V2, V3 and V4 are affected (ST elevation or depression) in an ECG what wall is this looking at of the heart?

What coronary artery is therefore affected?

A

Anteroseptal

Left Anterior Descending artery

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11
Q

If leads I, aVL, V5 and V6 are affected (ST elevation or depression) in an ECG what wall is this looking at of the heart?

What coronary artery is therefore affected?

A

Lateral wall

Circumflex

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12
Q

What can be viewed in an ECG with a STEMII?

A

ST elevation
T wave inversion
Pathological Q waves

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13
Q

What isoforms of Troponin are measured and are specific to cardiac myocyte death?

A

Troponin I
Troponin T

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14
Q

What type of ultrasound is used to view the heart to assess coronary arteries?

A

Echocardiogram

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15
Q

What drugs are used in the management of a STEMI?

A

Aspirin (Antiplatelet)
Ticagrelor (Anticoagulant)
Morphine (Analgesic)
Metoclopramide (Antiemetic/anti vomit)

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16
Q

How can NSTEMI be managed?

A

Antiplatelet (Aspirin)
Anti-Ischaemic (Bisoprolol/Slows heart) Atenolol is just an older version of Bisoprolol, Bisoprolol is even more cardiac specific than Atenolol

Statins (Atorvastatin)

ACE inhibitors

17
Q

What must happen if a patient has ongoing chest pain and dynamic ECG changes?

A

Urgent Percutaneous Coronary Intervention (PCI)

18
Q

When doing a Percutaneous Coronary Intervention, what arteries does the balloon angioplasty pass through to reach the coronary artery?

A

Radial artery
Brachial artery
Axillary artery
Subclavian artery
Aorta then Coronary artery

19
Q

What lifestyle changes could somebody do to reduce risk factors of acute coronary syndrome?

A

Low fat diet
Regular exercise
Low salt
Smoking cessation

20
Q

What does Bisoprolol do?

A

Decrease HR
B1 adrenergic receptor antagonist

21
Q

What area of the heart is being looked at by Leads II, III and aVF?

If there is ST elevation here what coronary artery is occluded?

A

Inferior wall

Right Coronary Artery

22
Q

What area of the heart is being looked at by Lead V1, V2, V3 and V4?

If there is ST elevation here what coronary artery is occluded?

A

Anteroseptal and anteroapical

Left Anterior Descending (LAD)

23
Q

What area of the heart is being looked at by Leads I, aVL, V5 and V6?

If there is ST elevation here what coronary artery is occluded?

A

Anterolateral

Circumflex artery

24
Q

What area of the heart does V1 and V2 look at?

A

Anteroseptal

25
Q

What area of the heart does V3 and V4 look at?

A

Anteroapical

CVS (21 decks)

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