Acute Coronary Syndrome Overview
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Questions and Answers

Which of the following medications is used as an emergency treatment for myocardial infarction?

  • Anistreplase (correct)
  • Atorvastatin
  • Atenolol
  • Lisinopril

    • What is the primary function of the sinoatrial (SA) node in the heart?

  • Facilitates blood flow through the ventricles
  • Generates spontaneous action potentials (correct)
  • Controls blood pressure regulation
  • Delays impulse to allow atrial contraction

    • Which non-pharmacologic therapy is recommended for managing stress?

  • Reduce physical activity
  • Limit vegetable consumption
  • Join a support group (correct)
  • Increase sodium intake

    • What is one therapeutic outcome of emergency medication for myocardial infarction?

    <p>Prevention of coronary artery reocclusion</p> Signup and view all the answers

    Where does the impulse travel after the atrioventricular (AV) node?

    <p>Through the Bundle of His</p> Signup and view all the answers

    Why is it important to check cholesterol levels regularly?

    <p>To prevent heart disease and manage overall health</p> Signup and view all the answers

    Which part of the heart is responsible for conducting impulses to the ventricular muscle?

    <p>Purkinje fibers</p> Signup and view all the answers

    What should be included in a heart-healthy diet?

    <p>Whole grains and vegetables</p> Signup and view all the answers

    What does STEMI represent in Acute Coronary Syndrome?

    <p>ST Elevation Myocardial Infarction</p> Signup and view all the answers

    Which clinical manifestation is NOT typically associated with Acute Coronary Syndrome?

    <p>Bleeding from the nose</p> Signup and view all the answers

    What is the primary cause of Acute Coronary Syndrome?

    <p>Atherosclerosis leading to plaque rupture</p> Signup and view all the answers

    Which of the following is a non-modifiable risk factor for Acute Coronary Syndrome?

    <p>Family history</p> Signup and view all the answers

    When should a 12-lead ECG be obtained for a suspected case of acute ischemic chest discomfort?

    <p>Immediately upon arrival at the emergency department</p> Signup and view all the answers

    What is the primary reason for obtaining a baseline complete blood count (CBC) in patients receiving antithrombotic therapy?

    <p>To evaluate the risk of bleeding</p> Signup and view all the answers

    What is the role of the Troponin I or T Test in diagnosing myocardial injury?

    <p>To check for heart muscle damage over time</p> Signup and view all the answers

    Which test is specifically useful for identifying patients with an ejection fraction of 40% or less?

    <p>Echocardiogram</p> Signup and view all the answers

    Unstable Angina is characterized by which of the following?

    <p>Imbalance of myocardial oxygen supply and demand without infarction</p> Signup and view all the answers

    What role do beta blockers play in cardiac treatment?

    <p>Decrease oxygen demand</p> Signup and view all the answers

    Which statement best defines Non-ST-Elevation Myocardial Infarction (NSTEMI)?

    <p>Imbalance between myocardial oxygen supply and demand resulting in subendocardial damage</p> Signup and view all the answers

    Which pharmacologic therapy is known for its antiplatelet effects through the inhibition of platelet cyclooxygenase-1?

    <p>Aspirin</p> Signup and view all the answers

    Which imaging procedure uses a radioactive substance to assess blood flow through the heart muscle?

    <p>Myocardial perfusion imaging</p> Signup and view all the answers

    What is the primary benefit of using angiotensin-converting enzyme (ACE) inhibitors in heart treatment?

    <p>Improve blood flow and reduce strain on the heart</p> Signup and view all the answers

    What is the purpose of a stress test in cardiovascular diagnostics?

    <p>To evaluate heart function during physical exertion</p> Signup and view all the answers

    Which medication is most commonly used for immediate breakdown of clots?

    <p>Thrombolytics</p> Signup and view all the answers

    Which component of the electrocardiogram (ECG) specifically represents atrial depolarization?

    <p>P wave</p> Signup and view all the answers

    What does the PR interval represent in the context of cardiac conduction?

    <p>Spread of impulses from the atria through the Purkinje fibers</p> Signup and view all the answers

    Which phase of the action potential corresponds to the ST segment on the ECG?

    <p>Phase 2 - Absolute refractory period</p> Signup and view all the answers

    What effect does increased automaticity of the SA node have on heart rate?

    <p>Causes sinus tachycardia</p> Signup and view all the answers

    Which statement best describes the T wave in the electrocardiogram?

    <p>Reflects phase 3 of ventricular repolarization</p> Signup and view all the answers

    What is the primary consequence of decreased SA node automaticity?

    <p>Slow heart rate (sinus bradycardia)</p> Signup and view all the answers

    Which of the following statements about the QRS complex is accurate?

    <p>It reflects ventricular depolarization.</p> Signup and view all the answers

    What phenomenon is commonly associated with abnormal automaticity of the SA node?

    <p>Cardiac arrhythmias</p> Signup and view all the answers

    Study Notes

    Acute Coronary Disease/Syndrome

    • Acute Coronary Syndrome (ACS) is a critical diagnosis needing immediate evaluation in patients presenting with acute chest pain.
    • ACS results from sudden reduced coronary blood flow, leading to cardiac ischemia.
    • Types of ACS include:
      • ST-Elevation Myocardial Infarction (STEMI): Complete blockage of a coronary artery, resulting in transmural infarct.
      • Non-ST-Elevation Myocardial Infarction (NSTEMI): Imbalance between myocardial oxygen supply and demand, causing non-transmural (subendocardial) infarct.
      • Unstable Angina: Imbalance between myocardial oxygen supply and demand, leading to myocardial ischemia but not infarction.

    Pathophysiology of ACS

    • ACS is often associated with atherosclerosis, a condition where fatty deposits (plaques) accumulate in the coronary arteries.
    • Plaque rupture can lead to blood clot formation, partially or completely obstructing blood flow to the heart muscle.
    • Insufficient oxygen supply to heart muscle cells can cause cell death and damage to muscle tissue, leading to a heart attack.

    Potentiating Factors of ACS

    • Modifiable: Hypertension, high cholesterol (hyperlipidemia), smoking, diabetes, obesity, physical inactivity, and excessive alcohol consumption.
    • Non-modifiable: Age, family history, and gender.

    Clinical Manifestations of ACS

    • Chest pain
    • Shortness of breath
    • Sweating
    • Nausea and vomiting
    • Fatigue and weakness
    • Palpitations

    Laboratory and Diagnostic Tests for ACS

    • 12-lead ECG: Records the heart's electrical activity to identify ischemic chest discomfort.
    • Troponin I or T test: Measures heart muscle damage.
    • Complete blood count (CBC) and coagulation studies: Assess risk of bleeding with antithrombotic therapy.
    • Serum Creatinine (SCr) and Creatinine clearance (CrCl): Assess kidney function, important for medication dosage adjustments.
    • Echocardiogram : Assess heart function and ejection fraction (EF).
    • Stress test: Evaluates heart function during physical exertion.
    • CT scan: Examines coronary arteries for blockages.
    • Myocardial perfusion imaging: Assesses blood flow through the heart muscle.

    Treatment and Management of ACS

    • General Approach: Hospital admission, oxygen administration, continuous ST-segment monitoring, frequent vital sign checks, and pain relief.
    • Pharmacologic Therapy:
      • Nitrates (NTG): Promote vasodilation.
      • Aspirin: Inhibits platelet aggregation.
      • Platelet P2Y12 Inhibitors (clopidogrel, prasugrel, ticagrelor): Prevent platelet aggregation.
      • Beta Blockers (metoprolol, propranolol, atenolol): Lower heart rate and oxygen demand.
      • ACE inhibitors (lisinopril, benazepril): Improve blood flow.
      • Statins (lovastatin, simvastatin): Lower cholesterol.
      • Thrombolytics (anistreplase, reteplase, streptokinase): Dissolve clots in emergencies.
    • Non-pharmacologic Therapy: Maintaining a healthy weight, stress management, controlling blood pressure and cholesterol, and maintaining a heart-healthy diet.

    Therapeutic Outcomes of ACS Treatment

    • Restoration of blood flow to the infarct-related artery.
    • Prevention of death and other complications.
    • Prevention of coronary artery reocclusion.
    • Relief of ischemic chest discomfort.
    • Resolution of ST-segment and T-wave changes on the ECG.
    • Relieve pain and distress
    • Enhanced quality of life

    Arrhythmia

    • Arrhythmias are irregular heartbeats caused by problems with the heart's electrical system.
    • Arrhythmias are classified by heart rate: Tachycardia when heart rate is greater than 100 bpm and Bradycardia when heart rate is less than 60 bpm.
    • Pathophysiology of Arrhythmias:
    • Abnormal impulse initiation: Problems with the heart's natural pacemaker (SA node) can result in slow or fast heart rates.
    • Abnormal impulse conduction: Problems with the electrical pathways of the heart can lead to problems delivering impulses and improper electrical conduction.
    • Types of Arrhythmias:
    • Supraventricular arrhythmias
    • Ventricular arrhythmias.
    • Clinical manifestations of Arrhythmias include palpitations, dizziness, fainting, fatigue, shortness of breath, chest pain, anxiety and sudden cardiac arrest.
    • Additional clinical manifestations may be needed for proper diagnosis.
    • Diagnosis of Arrhythmias:
    • Electrocardiogram (ECG): Records electrical activity of the heart.
    • Electrophysiology study (EPS): Measures electrical activity of the heart in detail.
    • Blood tests: Check electrolytes, thyroid levels, and other relevant values.
    • Imaging tests like CT and MRI
    • Treatment of Arrhythmias:
    • Pharmacologic and Non-Pharmacologic Treatment.
    • Note: Detailed information on medications and specific arrhythmia types will vary from those listed above.

    Cardiopulmonary Arrest

    • Cardiac arrest is a sudden, complete cessation of the heart's electrical activity and mechanical pumping ability.

    • This results in lack of blood circulation and the immediate cessation of delivering oxygen to the body.

    • Pathophysiology of Cardiac Arrest includes:

    • Primary: fully oxygenated blood

    • Secondary: lack of ventilation resulting in hypoxemia, hypotension and cardiac arrest.

    • Clinical manifestations include : Loss of consciousness, Sudden Collapse, Anxiety, Shortness of breath, chest pain and nausea.

    • Diagnosis of Cardiac Arrest:

    • Electrocardiogram (ECG): records heart electrical activity.

    • Electrolyte imbalances may need checking.

    • Cardiac enzymes and imaging may be used for certain diagnostic needs.

    • Treatment of Cardiac Arrest:

    • Immediate Recognition

    • Early CPR

    • Rapid Defibrillation

    • Advanced Cardiac life support (ACLS).

    • Pharmacologic treatment such as epinephrine, vasopressin, amiodarone, lidocaine and magnesium may be used in appropriate circumstances.

    • Non-pharmacologic therapy includes CPR, defibrillation, ventilation, placement of IV, and intraosseous access.

    • Post-resuscitative care including airway support and oxygenation and hypothermia if indicated.

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    Group 1 ACS Arrhythmia CPS PDF

    Description

    This quiz covers Acute Coronary Syndrome (ACS), including its types such as STEMI and NSTEMI, as well as the pathophysiology associated with the condition. Gain insights into the critical diagnosis and underlying processes involved in ACS. Test your knowledge on how atherosclerosis and plaque rupture contribute to heart health.

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