Lecture 9 A cute coronary syndrome Flashcards
Angina + ….
ST elevation indicates ______;
ST depression/T inversion with raised troponin indicates ______;
ST depression/T inversion w/o raised troponin indicates _____
STEMI;
Non-STEMI;
unstable angina
ST elevation +/- Q waves in leads ____ to ____ indicates acute anterior STEMI. what blood vesse
V1-V4; LAD
ST elevation in leads II, III, and aVF indicates an infarction where?
inferior (ie of RCA)
ST elevation in leads I and aVL ( and sometimes V5, V6) indicates a ______ wall STEMI. due to occlusion of what blood vessel?
lateral, Left circumflex
the use of what common drug in acute MI is associated with INCREASED mortality?
morphine
nitrates work by increasing levels of ____, causing vaso____
NO, dilation
3 symptoms/signs associated with RV infarction:
what drug should not be used in this
hypotension, JVD, clear lungs
nitrates
______ are contra-indicated in patients with hypotension, bronchospasm, bradycardia, or suspected coronary spasm
beta blockers
beta blockers cause an increase in ____ in the heart = increased blood flow
collaterals
what drug has been shown to decrease mortality the most in patients with acute coronary syndrome? what is number 2?
aspirin (50%); beta blockers (43%)
generally, beta blockers cause a large decrease in ____ and a small to negligible increase in ____; _____ the O2 defecit
demand, supply; lowering
mechanism of action for clopidogrel
ADP receptor inhibitor
compared to clopidrogel, ____ and _____ have decreased risk of death/MI but increased risk of bleeding
prasugrel, ticagrelor
heparin activates _____. what is preferred to heparin? give an example of a drug in this class
antithrombin III, Low molecular weight heparin;
enoxaparin
Mechanism of action of abciximab and tirofiban?
GpIIb/IIIa inhibitors (prevent platelet aggregation)
