Acute Coronary Syndrome Overview

Platelets primarily form the thrombus.

The three types are NSTEMI, STEMI, and unstable angina.

Aspirin is a mainstay treatment.

<p>A silent myocardial infarction is when chest pain is not experienced; patients with diabetes are particularly at risk.</p> Signup and view all the answers

<p>Pathological Q waves suggest a transmural infarction.</p> Signup and view all the answers

<p>Troponin levels rise in the context of myocardial ischemia, helping to diagnose NSTEMI.</p> Signup and view all the answers

<p>The chest pain is central and constricting, often lasting more than 15 minutes.</p> Signup and view all the answers

<p>A high or rising troponin level indicates myocardial ischemia, consistent with an NSTEMI.</p> Signup and view all the answers

<p>STEMI is diagnosed when the ECG shows ST elevation.</p> Signup and view all the answers

<p>NSTEMI is diagnosed when there is a raised troponin level.</p> Signup and view all the answers

<p>A normal troponin level suggests unstable angina or another non-cardiac cause.</p> Signup and view all the answers

<p>The mnemonic is 'CPAIN': C – Call an ambulance P – Perform an ECG A – Aspirin 300mg I – Intravenous morphine for pain if required (with an antiemetic, e.g., metoclopramide) N – Nitrate (GTN)</p> Signup and view all the answers

<p>Patients who experienced pain within the last 72 hours should be referred.</p> Signup and view all the answers

<p>Patients should be discussed for urgent PCI or thrombolysis.</p> Signup and view all the answers

<p>Angiography assesses the coronary arteries and identifies blockages.</p> Signup and view all the answers

<p>The mnemonic is 'DREAD' for complications: D – Death R – Rupture of the heart septum or papillary muscles E – “oEdema” (heart failure) A – Arrhythmia and Aneurysm D – Dressler’s Syndrome</p> Signup and view all the answers

<p>Dressler’s syndrome occurs 2-3 weeks after a myocardial infarction.</p> Signup and view all the answers

<p>Management includes NSAIDs such as aspirin or ibuprofen.</p> Signup and view all the answers

<p>Close monitoring of renal function is required.</p> Signup and view all the answers

<p>Dual antiplatelet therapy prevents stent thrombosis.</p> Signup and view all the answers

<p>Global ST elevation and T wave inversion indicate myocardial infarction.</p> Signup and view all the answers

<p>The RCA supplies blood to the right side and under the heart, including parts of the right atrium and right ventricle.</p> Signup and view all the answers

<p>Typical myocardial infarction presents with chest pain, while silent myocardial infarction may occur without noticeable symptoms, especially in patients with diabetes.</p> Signup and view all the answers

<p>Troponins are proteins released from ischaemic cardiac muscle, and elevated levels indicate myocardial ischaemia or damage.</p> Signup and view all the answers

<p>The circumflex artery supplies blood to the left atrium and parts of the left ventricle, ensuring adequate perfusion to these heart regions.</p> Signup and view all the answers

<p>Chest pain is usually central, constricting, and lasts longer than 15 minutes, often worsening at rest.</p> Signup and view all the answers

<p>A rise in troponin levels suggests myocardial ischaemia and supports the diagnosis of NSTEMI.</p> Signup and view all the answers

<p>Pathological Q waves appear 6 or more hours after ischemic symptoms and suggest a deep transmural infarction.</p> Signup and view all the answers

<p>Initial management includes discussing urgent referral to a cardiac center and considering medications like aspirin and prasugrel.</p> Signup and view all the answers

<p>Unstable angina is diagnosed when a patient shows symptoms suggestive of acute coronary syndrome, has normal troponin levels, and presents with certain clinical features.</p> Signup and view all the answers

<p>ECG findings are critical for diagnosing STEMI as they provide immediate information about heart activity, while troponin tests may not be as immediate.</p> Signup and view all the answers

<p>NSTEMI is diagnosed through elevated troponin levels and clinical context, whereas STEMI is identified through specific ECG changes.</p> Signup and view all the answers

<p>The &quot;CPAIN&quot; mnemonic helps recall crucial steps: Chest Pain assessment, Pain relief, Antiplatelet agents, Initial investigations, and Nitro-glycerine if needed.</p> Signup and view all the answers

<p>Aspirin acts as an antiplatelet medication, helping to prevent further thrombus formation in the coronary arteries.</p> Signup and view all the answers

<p>STEMI is characterized by ST elevation on the ECG, whereas NSTEMI does not show such elevation but has elevated troponin levels.</p> Signup and view all the answers

<p>The GRACE score estimates the risk of death within six months following an NSTEMI, informing decisions about urgency for angiography.</p> Signup and view all the answers

<p>The DREAD mnemonic includes: Dressler's syndrome, Rupture of myocardium, Electrophysiological disturbances, Aneurysm, and Death.</p> Signup and view all the answers

<p>ACE inhibitors can lead to hyperkalaemia and must be monitored closely in patients also taking aldosterone antagonists.</p> Signup and view all the answers

<p>Thrombolysis involves administering fibrinolytic agents to dissolve blood clots, with careful consideration of bleeding risks.</p> Signup and view all the answers

<p>Diagnosis of Dressler's syndrome is made through clinical features like pleuritic chest pain, along with ECG changes, echocardiogram findings, and elevated inflammatory markers.</p> Signup and view all the answers

<p>Dual antiplatelet therapy regimens are influenced by the type of stent, with varying durations for bare-metal and drug-eluting stents.</p> Signup and view all the answers