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8 Cards in this Set
- Front
- Back
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What are characteristics of STEMI?
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(transmural Q-wave MI) complete occlusion,
ST elevation > 1mm in 2 or more contiguous limb leads or >2 mm in 2 or more contiguous precordial leads |
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What are characteristics NSTEMI?
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or non Q wave MI (subendocardial) partial or transient occlusion; spontaneous revascularization
- often has more than one vessel involved |
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What is the overall goal with STEMI when presented?
What are the four types of therapy at your disposal? |
Goal – limit thrombus formation and alleviate obstruction.
1. Anti platelet therapy – ASA, clopidogrel 2. Anticoagulants – Heparin 3. Chemical dissolution – fibrinolytic agents 4. Mechanical disruption – PCI – percutaneous coronary intervention or angioplasty |
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Routine measures in early management of ASC for NSTEMI.
What if high risk? |
Access TIMI risk score
High 5-7 Medium- 3-4 Low- 0-2 High and Medium risk have same initial therapy- 1. ASA, BBC, Nitrates, LMWH, or UFH, statin, GPIIb/IIa inhibitor, clopidogrel and early coronary angiography |
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Routine evaluation for STEMI?
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1. time of onset
2. high risk features (shock, heart failure favor PCI) 3. Risk of Thrombolytic therapy 4. Time to achieve balloon inflation with PCI |
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What are absolute contraindications of clot busters?
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1. Any prior intracerebral hemorrhage
2. Known cerebrovascular lesion 3. Ischemic strone within 3 months 4. Suspected aortic dissection 5. Active bleeding except menses 6. Significant closed head or facial trauma within 3 months |
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Whats the most important issue in TLT (thrombolytic agent therapy)?
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Most important issue in TLT is not which agent to use, but how quickly to use it. “Door to Needle” < 30 min
“Door to ECG” < 10 min |
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What is the difference between diagnosing a NSTEMI and unstable angina?
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both can show T-wave inversion or ST segment inversion
- Only know by enzyme analysis - ENZYMES elevated = NSTEMI -ENZYMES normal = unstable angina |
