Pathophys of Acute Coronary Syndrome

Question 1

STEMI

Answer 1

Ruptured plaque -> complete thrombosis and 100% occlusion. NonSTEMI just partial

Question 2

2 Downstream Effects Distal to Coronary Obstruction

Answer 2

Get distal embolizations from small things that break off and occlude smaller vessels, and also vasoconstriction from 5HT and Endothelin-1

Question 3

Necrosis Wavefront

Answer 3

Necrosis goes from inner heart layers-> out

Question 4

Q Wave

Answer 4

NonSTEMI and STEMI can each also be classified as Non-Q-Wave MI or Q-Wave MI. But retrospective so kinda useless and not really used

Question 5

ST Elevation vs. Depression in Terms of Current/Future Outcomes

Answer 5

Elevated has higher risk of dying immediately, but depressed continue to have rising mortality for next few months

Question 6

2 Biomarkers

Answer 6

CKMB - very quick

Troponin - very sensitive

Question 7

Size of Infarction by Biomarkers

Answer 7

Size under curve associated w/ size of infarct

Question 8

Widowmaker

Answer 8

Obstruction at origin of L ant descending coronary a.

Question 9

3 Consistent Independent Predictors of 30 Day Death/MI

Answer 9

Age
Elevated CK
ST depression

Question 10

TnT and Survival

Answer 10

(-) more likely to survive

Question 11

BNP and Mortality

Answer 11

Higher BNP -> higher mortality

Question 12

Anterior MIs vs. Non-Anterior MI Mortality

Answer 12

Ant more fatal