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TERM 3 N2161 KNLG 2 > WEEK 3 ACS > Flashcards

WEEK 3 ACS Flashcards

1
Q

How is angina described to feel like?

A

Constrictive, squeeze, heavy, choking, suffocating, indigestion, epigastric burning

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2
Q

Where does angina radiate to?

A

Arm, jaw, back

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3
Q

What are the atypical angina symptoms that women often have?

A

Fatigue, anxiety, indigestion, SOB

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4
Q

What atypical angina symptoms do elderly patients often have?

A

Weakness, syncope, SOB, diaphoresis

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5
Q

What causes diabetic patients to often have atypical angina symptoms?

A

Autonomic neuropathy

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6
Q

Which 2 substances are the cause of angina?

A

Lactic acid and troponin

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7
Q

What are the differences between chronic stable angina and unstable angina?

A

Chronic stable angina: Predictable, lonstanding, episodic, relieved with rest or nitroglycerin

Unstable angina: New onset; increasing frequency, duration, and severity; comes on at rest or with exertion; resistant to nitroglycerin

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8
Q

What 3 conditions are encompassed by the term Acute Coronary Syndrome (ACS)?

A
  1. Unstable angina
  2. NSTEMI
  3. STEMI
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9
Q

Explain the difference between unstable angina and MI

A

Unstable angina has negative trop, MI has positive trop

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10
Q

Explain the difference between NSTEMI and STEMI

A

NSTEMI: Partial or transient obstruction, no ST elevation, urgent treatment

STEMI: Complete obstruction, ST elevation, immediate treatment

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11
Q

Why is stable angina predictable and related to exertion, while unstable angina is experienced at rest?

A

Stable angina = demand-led ischemia
Unstable angina = supply-led ischemia

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12
Q

Define acute coronary syndrome (ACS)

A

Prolonged, irreversible myocardial ischemia

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13
Q

What is the ST segment on ECG?

A

Segment in between ventricular depolarization and repolarization

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14
Q

What does a depressed ST segment indicate?

A

Myocardial ischemia

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15
Q

Name 4 complications of MI

A
  1. Heart failure
  2. Dysrythmia
  3. Cardiogenic shock
  4. Pericarditis
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16
Q

How does MI lead to cardiac dysrhythmia?

A

Lack of blood flow alters sensitivity to nerve impulses (e.g. v-fib: can cause sudden cardiac death)

17
Q

How does MI lead to cardiogenic shock?

A

Result of severe LV failure post MI (i.e. reduced ejection fraction)

18
Q

For clients with ACS, what are the expected diagnostic studies to be performed?

A
  1. ECG
  2. Trop (unless positive STEMI, then straight to angio)
  3. Angio
  4. Echo
  5. CXR
19
Q

What is troponin, and how long does it remain in the blood?

A

Released from damaged myocardium, peaks at 4-6 hrs and remins in blood for 10-14 days after

20
Q

What is creatine-kinase MB, and how long does it remain in blood?

A

Enzyme found in cardiac muscle. Peaks early and gone in 48 hrs.

21
Q

Why are CBC, PT, and INR checked in ACS patients?

A

To assess if they can be treated with anticoagulants or clot busters

22
Q

Why are kidney function tests checked in ACS patients?

A

To assess if they can excrete contrast medium from angio, and what drugs the patient can receive post MI

23
Q

What other lab tests are screened for ACS?

A

INR, PT
Lip/Chol
CBC
Lytes
Kidney function tests (BUN, Cr, GFR)
Grp + screen

24
Q

What is the normal range for troponin 1?

A

Less than 0.04 ng/ml

25
Q

What is the normal range for high sensitivity troponin?

A

Less than 0.14 ng/L

26
Q

What is the normal range for CKMB?

A

Less than 20-30 U/L

27
Q

What is the normal range for Hgb?

A

120-180 g/L

28
Q

What is the normal range for RBCs?

A

4.2 to 6 cells/mcL

29
Q

What is the normal range for platelets?

A

150000-400000 plt/mcL

30
Q

Which intervention usually happens right after angiogram, where the blockage is immediately opened with stent/balloon?

A

Percutaneous coronary intervention/angioplasty (PCI)

31
Q

What is the medical term for clot busters?

A

Thrombolytic therapy

32
Q

What intervention involves taking a healthy blood vessel from the chest or leg area, connecting it below the blocked heart artery, creating a new pathway for blood flow to the heart muscle?

A

Coronary artery bypass graft (CABG)

33
Q

What are the 3 goals of pharmacotherapy for ACS?

A
  1. Decrease workload of heart
  2. Decrease oxygen demand
  3. Increase oxygen supply
34
Q

What does the acronym MONA stand for?

A

Morphine
Oxygen
Nitro
ASA

35
Q

What is the actual order of priority for MONA?

A

Oxygen
Nitro
ASA
Morphine

36
Q

What are 3 signs that coronary reperfusion has occured?

A
  1. Normalization of ST segment
  2. Relief of chest pain
  3. Vitals stabilize (possible reperfusion dysrhythmias that subside within a few minutes without treatment)
37
Q

Why are ACS patients put on laxatives?

A

Prevent straining and increased O2 demand

38
Q

What kind of diet is recommended for post MI patients?

A

Meditarranean: Low salt, healthy fats, balanced diet, antioxidants

39
Q

What kind of exercise is recommended for post MI patients?

A

Cardio, not weights

TERM 3 N2161 KNLG 2 (13 decks)

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