MI Flashcards
chronic stable angina causes pain on?
exertion
ACS causes pain on?
rest
what causes MI?
occlusion of coronary artery due to rupture of athersclerotic plaque
factors affecting atherosclerotic plaque rupture
fibrous cap thickness lipid content intraluminal pressure change mechanical injury shape bending/twisting
how do platelets aggregate to form a clot on a ruptured plaque
extend pseudopodia to collect platelets and ADP and TXA2 secretion
true/false - aspirin stops production of ADP
false - stops production of TXA2
clopidogrel/prasugrel/ticagrelor prevent ___ binding to platelet surface?
ADP
what ST changes may be seen in STEMI?
> 1mm in 2 adjacent limb leads
>2mm in 2 contiguous precordial
what is LBBB
left bundle branch block
wide QRS>120mm with IV conduction delay
can T wave inversion still be STEMI sign?
yes! it is just slightly older. you need to check previous ECG
anteroseptal MI leads
V1-4
anterolateral MI leads
V1-6, I, aVL
inferior MI leads
II, III, aVF
what cardiac enzyme may be used if no ECG changes seen?
troponin
first line treatment for MI
MONA+C
indication for reperfusion within 2 hours?
STEMI
if a patient cannot receive PCI in 90 mins of ECG diagnosis of STEMI what should be done
thrombolysis
when can GTN be given to MI patient
when SBP >90 mmHg
arrhythmic complications MI
VF
Structural complications MI
VSD Cardiac rupture mitral valve regurg left ventricular aneurism mural thrombus inflammation acute pericarditis dresslers syndrome
Functional complications MI
Acute ventricular failure
chronic cardiac failure
cardiogenic shock
what are the ECG changes associated with NSTEMI
normal or st depression
is the main clot in NSTEMI the issue?
no, it is the micro infarcts that are
cardiac specific troponins?
T and I
managing NSTEMI
MONA+C
LMWH or fondaparinux, aspirin and clopidogrel/ticagrelor
beta blocker and group IIb/IIIa inhibitors
how long is it recommended a PCI patient should be on antiplatelets for?
6m
when else may troponins be raised?
CCF Hypertensive crisis PE Renal failure sepsis stroke/TIA pericarditis/myocarditis post arrhythmia
what is cardiac arrest
effective cessation of the heart
causes of airway issues
tongue blocking
blocked lumen
swelling
muscle spasm
treating airway obstruction
head tilt chin lift
adjunct
ETT
O2
causes of breathing issues
muscle weakness
nerve damage
haemothorax
pneumothorax
treating breathing issues
airway secured
oxygen
ventilate bag mask
primary causes cardiac issues
ACS
drugs
arrhythmia
secondary causes cardiac issues
hypovolaemia
asphyxia
hypothermia
septic shock
treating cardiac issues
IV/IO access
fluids/vasopressors/inotropes/aspirin/
morphine
what level would you treat blood glucose
<3 mmol/l
4 Hs
Hypoxia
Hypothermia
Hypoolaemia
hypo/hyperkalaemia
4Ts
thrombosis
tension PTX
cardiac Tamponade
toxins
