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22 Cards in this Set
- Front
- Back
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3 Acute Coronary Syndromes
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Sudden Cardiac Death
Acute Myocardial Infarction Unstable Angina |
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Complications of Atherosclerotic Plaques?
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Acute Change in Plaque
Platelet Aggregates Thrombosis Vasospasm |
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Types of Acute Changes in plaques?
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Fissuring of Surface
Hemorrhage into gruel Rupture of fibrotic capsule (emboli) |
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2 causes of vasospasm?
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Anxiety
Cocaine! |
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Define ACS?
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Any constellation of clinical Sx's that are compatible w/ acute myocardial ischemia
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On average how long does Angina Pectoris last?
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5-15 minutes
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What % of AP involves fixed stenosis?
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50-90%
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On average, how long does unstable angina last?
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< 30 minutes
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How do Cardiac Enzymes help Dx ACS's?
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They are elevated in MI, but not in Angina
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EKG changes in MI?
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ST elevation or depression
T wave inversion |
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Types of MI?
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STEMI: ST elevation = Transmural
NSTEMI: No ST elevation = subendocardial |
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ACS Etiologies?
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-Occlusive or Non-Occlusive Thrombus on plaque which ruptured or eroded
-Dynamic Obstruction -Progressive Mechanical Obstruction -Inflammation or Infection -Secondary ACS (e.g. disease increases O2 demand) |
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What percent of ED visits are for chest pain?
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8% (8 million)
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Of those 8% how many get sent home?
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~37% (3 million)
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Of those sent home, what percent had MI's?
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over 1% (40,000)
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Of the 5 million admitted to hospital, how man were noncardiac?
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Half
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How many were UA, MI, or dead?
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UA: 24%
MI: 20% Dead: 6% |
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Rx guidelines for UA?
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Assess risks
Determine risk level Target therapy to risk Anti-ischemic, antithrombotic Rx Invasive (cath) vs conservative\ Discharge planning |
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High Risk Features in the ED?
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Accelerated Pattern of Angina
Duration of >20 minutes Signs of CHF Hemodynamic Instability Arrhythmias >75 yrs Ischemic ECG changes Elevated markers |
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When auscultating MI, what might you hear?
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Gallop Rhythm
Murmur |
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Acute Rx for UA/NSTEMI?
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ANTI-ISCHEMIC Rx
O2 Bed Rest ECG monitoring Beta Blockers NO ACE Inhibitors ANTITHROMBOTIC RX Antiplatelet Anticoagulative |
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So you just Dx Stable Angina in a patient, what is appropriate management?
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Aspirin
Beta Blockers Check Lipids Schedule Stress Test |
