T1: Acute Coronary Syndrome (2) Flashcards
What area of the heart is the most frequent site of MI?
Left Ventricle
Why is the LV the most frequent site of MI?
It is the larger muscle, does most of the work so more blood is required there
Type of damage to heart muscle that involve ALL 3 cardiac layers:
Transmural
Type of damage to heart that is limited, does not involve all layers:
Nontransmural
What are the 3 cardiac layers?
ENDOcardium
MYOcardium
EPIcardium
What layers may be affected by nontransmural damage, but not all at once?
- subendocardial
- endocardium
- epicardium
- subepicardium
Anterior wall MI:
- Major vessel
- ECG leads
- LAD
- V3-V4
(Remember: the “Vs” look like upside down A for Anterior)
Inferior wall MI:
- Major vessel
- ECG leads
- RCA
- II, III, aVF
(Remember: II & III look like I for Inferior)
Blockage in the left main coronary artery is nicknamed the _____.
widowmaker
major damage - feeds the LV
Prominent ST elevation is nicknamed _____. Why?
tombstone
high likelihood of death
Is MI pain relieved by NTG or rest?
No
Location of MI pain?
beneath sternum
epigastric
Duration of MI pain?
> 30 min
Remember: 20 min is the limit for cardiac muscle
Quality of MI pain?
Pressure, burning
Radiation of MI pain?
back, neck, jaw, left arm
Associated symptoms of MI pain?
N/V
diaphoresis
4 Biomarkers of MI:
- Troponin I
- Troponin T
- CK-MB
- Myoglobin
Normal value of Troponin I:
less than 0.03 ng/L
Troponin I elevates after ___ hrs and peaks at ___ hrs. Returns to normal in ___ - ___ days.
elevates: 3 hrs
peaks: 24 hrs
normalizes: 5-10 days
Normal value of Troponin T:
less than 0.2 ng/L
Troponin T elevates after ___-___ hrs and peaks at ___-___ hrs. Returns to normal in ___-___ days.
elevates: 3-5 hrs
peaks: 12-48 hrs
normalizes: 14-21 days
Normal value of CK-MB?
0%
CK-MB elevates after ___-___ hrs and peaks at ___ hrs. Returns to normal in ___-___ days.
elevates: 4-6 hrs
peaks: 24 hrs
normalizes: 2-3 days
Normal value for myoglobin:
less than 90 mcg/L
