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20 Cards in this Set
- Front
- Back
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Acute Coronary Syndrome is...
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Chest pain/discomfort resulting from cardiac ischemia.
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3 types of Acute Coronary Syndromes
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1. Unstable Angina
2. NSTEMI 3. STEMI |
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Causes of Myocardial Infarction
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Most common: atherosclerosis in coronary artery followed by rupture of plaque, platelet activation, and fibrin clot formation.
Other causes: coronary artery spasm, embolus, congenital abnormalities, connective tissue disorders. |
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Symptoms of Unstable Angina
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-Angina at rest
-Previously dx stable angina that has become more severe, prolonged, frequent, or occurs at a lower threshold. |
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ECG changes seen with Unstable Angina/Trop
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Transient ST-segment or T-wave changes may occur
Trop- negative |
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Symptoms of NSTEMI
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-Chest pain or discomfort
-N/V -SOB -Unexplained weakness -Fatigue -Dizziness/lightheadedness -Syncope |
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ECG changes seen with NSTEMI/Trop
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-Evidence of ischemia
-ST-segment depression -T-wave abnormalities Trop- elevated |
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Symptoms of STEMI
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-Chest pain/discomfort
-N/V -SOB -Unexplained weakness -Fatigue -Dizziness/light headedness -Syncope |
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ECG changes seen with STEMI/Trop
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-Evidence of infarction
-ST-segment elevation >2mm in V1-3, >1 in other leads -New LBBB Trop- elevated |
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Levine's Sign
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Clenched fist against sternum
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What heart sound is almost universally present in ACS?
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S4
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What do Tall Peaked T-waves indicate?
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Ischemia-very early sign, subendocardium
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What do T-wave inversions indicate?
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Ischemia to the Myocardium
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What does ST-segment elevation indicate?
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Injury to Epicardium
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What do significant Q-waves indicate?
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Myocardial infarct. Appear within 24 hours of cell death (infarct). May be permanently present on all future EKGs.
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MONA-B
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Morphine,
Oxygen, Nitroglycerin, Aspirin, and a Beta-blocker |
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What are the benefits of Morphine in ACS
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Morphine acts as an analgesic, a sedative, it decreases preload and afterload, it reduces apprehension.
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Variant or Prinzmetal's Angina
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Coronary artery spasm-can occur with or without artherosclerotic changes.
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What are some characteristics of Variant Angina?
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Occurs at rest,
Clusters at night, triggered by ETOH, iced liquids, nicotine, REM sleep, or hyperventilation. |
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If you give a beta blocker to someone experiencing chest pain and pt's condition deteriorates, what might you consider?
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Coronary artery spasm from Variant or Prinzmetal's Angina.
Use Calcium Channel Blockers such as Diltiazem instead of Beta Blocker. |
