Week 2 - Acute Coronary Syndromes Flashcards
What are some acute coronary syndromes?
MI or unstable angina
What is the appearance of a plaque in acute coronary syndromes?
very thick fat and very thin fibrous cap, prone to rupture
What evidence do you need to diagnose myocardial infarction?
- symptoms of ischaemia,
- new ECG changes,
- coronary problem in angiogram
What protein helps in the diagnosis of an MI?
troponin. levels are high during heart attack
What are risk factors for STEMI?
- male,
- age,
- BP,
- LDL,
- known heart disease,
- smoker,
- diabetes
When do i see an ST elevation in an MI?
if the vessel is completely occluded, youll see ST elevation and get STEMI. if partially occluded, you get NSTEMI
What is reperfusion therapy vs thrombolysis for STEMI?
reperfusion uses baloon and stent to unblock artery. primary percutaneous coronary intervention
thrombolysis done anywhere. good if cant get to a cath lab for a percutaneous intervention within 2 hours
What investigations are carried out for MI?
many ECG’s for change
blood test for troponin
routine bloods - renal function, anaemia, cholesterol
What is type 1 vs type 2 MI?
type 1 is due to atheroma rupture. or clotting causing ischaemia.
type 2 is ischaemia due to myocardial o2 supply and demand mismatch
When would you do a coronary angiogram ?
- when you know its not type 2 MI.
- when benefits outweight risks
What are the risks associated with a coronary angiogram and percutaneous coronary intervention?
- bleeding from access site,
- MI,
- coronary perforation,
- stroke,
- may need more than stent - CABG
What is the treatment of MI?
GTN (vasodilates arteries quickly, relieving pain.)
opiates for pain
anticoagulants - aspirin
ACE inhibitors, b blockers, statins
How do you manage ACS in the hospital?
- keep on monitor 1-2 days.
- check heart for murmurs/signs.
- start prevention for secondary disease.
- look for complications
