Acute Coronary Syndromes Flashcards

Questions and Answers

ACS may suddenly strike men and women, often after years of _____________________________

asymptomatic coronary atherosclerosis and plaque formation

What is the main difference between stable angina and unstable angina?

Stable angina involves chest discomfort during exertion; unstable angina involves chest discomfort during rest.

What is a classic symptom of acute ischemic chest discomfort?

Pain radiating down the left arm is the correct answer.

What is the most common symptom of myocardial ischemia and infarction?

Retrosternal chest pain is the correct answer. Signup and view all the answers

What may a dispatcher instruct the patient to do before EMS arrives if they experience MI symptoms?

Chew 162-325 mg non-enteric coated aspirin. Signup and view all the answers

What is the most important thing for someone experiencing MI symptoms who does not need resuscitation?

12 lead EKG to determine if this could be a STEMI or NSTE-ACS. Signup and view all the answers

What is one goal of therapy for patients with ACS?

Relief of ischemic chest discomfort is the correct answer. Signup and view all the answers

What is the recommended dose of aspirin if not contraindicated?

162-325 mg Signup and view all the answers

What are contraindications for nitroglycerins?

Severe bradycardia, tachycardia, hypotension, phosphodiesterase inhibitors within the past 24-48 hours. Signup and view all the answers

Patients with inferior wall STEMI on their 12 lead EKG can often have _________________ involvement. If infarction is suspected, then are contraindicated.

right ventricular involvement; nitrates Signup and view all the answers

Reperfusion goals for STEMI patients include PCI within the first ______ minutes or _ within 30 minutes of ED arrival.

90 minutes after the first medical contact; fibrinolytics Signup and view all the answers

What is the preferred reperfusion therapy for STEMI patients?

PCI Signup and view all the answers

What is the initial drug therapy for ACS?

Oxygen (if needed), aspirin, nitroglycerin, morphine (if needed) Signup and view all the answers

What is PCI?

PCI opens the blocked artery with a tiny balloon and then a stent is placed to maintain blood flow to the heart. Signup and view all the answers

___________________________ is a general term for a group of life-threatening conditions that occur because of a sudden reduction in blood flow to the heart.

Acute coronary syndromes (ACS) Signup and view all the answers

What symptoms can indicate myocardial infarction?

Fatigue and weakness, nausea/vomiting, retrosternal chest pain, loss of consciousness. Signup and view all the answers

New ST-segment elevation in two or more contiguous leads on a 12-lead ECG suggests what?

myocardial infarction Signup and view all the answers

When a patient presents with possible ACS, how quickly should a 12-lead ECG be obtained and interpreted?

10 minutes Signup and view all the answers

Advance notification of the receiving facility by prehospital providers can improve outcomes for patients with STEMI.

True Signup and view all the answers

Patients with low- to intermediate-risk NSTE-ACS may show which changes on an ECG?

Nondiagnostic ST-segment changes Signup and view all the answers

For a patient experiencing STEMI, management focuses on early reperfusion therapy with:

Percutaneous coronary intervention (PCI) and fibrinolytic therapy. Signup and view all the answers

What is the dose of nitroglycerin (sublingual tablet or spray) to be administered to a patient suspected of having an acute coronary syndrome?

0.1 to 0.3 mg every 5 minutes Signup and view all the answers

Which findings on a 12-lead ECG would be expected in a patient with high-risk non-ST-segment elevation acute coronary syndromes (NSTE-ACS)?

ST-segment depression in two or more contiguous leads Signup and view all the answers

What findings on ECG suggest non-ST-segment elevation ACS (NSTE-ACS)?

ST-segment depression, T wave inversion Signup and view all the answers

Study Notes

Acute Coronary Syndromes (ACS)

ACS can develop suddenly, often after years of silent coronary atherosclerosis and plaque buildup.
It encompasses various life-threatening conditions due to sudden reduced blood flow to the heart.

Types of Angina

Stable angina: Chest discomfort occurs during physical exertion.
Unstable angina: Chest discomfort arises at rest, indicating a more serious condition.

Symptoms of Myocardial Ischemia

Classic symptom of acute ischemic chest discomfort includes pain radiating down the left arm.
Most common symptom of myocardial ischemia and infarction is retrosternal chest pain.

Emergency Response

Dispatchers may advise patients with myocardial infarction (MI) symptoms to chew 162-325 mg non-enteric coated aspirin, unless there is active or recent gastrointestinal bleeding.
For patients with MI symptoms who do not require resuscitation, obtaining a 12-lead ECG is critical to identify potential STEMI or NSTE-ACS quickly and improve diagnosis and reperfusion timing.

Treatment Goals and Medications

A primary goal in treating ACS is the relief of ischemic chest discomfort.
Recommended aspirin dose for treating ACS is 162-325 mg.
Contraindications for the use of nitroglycerin include severe bradycardia, tachycardia, hypotension, and recent use of phosphodiesterase inhibitors (within 24-48 hours).

STEMI Considerations

Patients with inferior wall STEMI may also have right ventricular involvement. If right-sided infarction is suspected, nitrates should be avoided.
Reperfusion strategies aim for percutaneous coronary intervention (PCI) within 90 minutes after initial medical contact or fibrinolytics within 30 minutes of ED arrival.
Preferred reperfusion therapy for STEMI patients is PCI.

Initial Drug Therapy for ACS

Initial therapy includes supplemental oxygen (if needed), aspirin, nitroglycerin, and morphine (if required).

ECG and Diagnostic Criteria

New ST-segment elevation in two or more contiguous leads indicates myocardial infarction.
A 12-lead ECG should be performed and interpreted within 10 minutes for potential ACS cases.
High-risk NSTE-ACS patients may show ST-segment depression in two or more contiguous leads, while non-ST-segment elevation ACS may present with ST-segment depression and T wave inversion.

Patient Management and Outcomes

Advanced notification of receiving facilities by prehospital providers is beneficial for improving STEMI patient outcomes.
For suspected acute coronary syndrome, nitroglycerin can be administered as a sublingual tablet or spray at a dosage of 0.1 to 0.3 mg every 5 minutes.

Additional Symptoms of Myocardial Infarction

Other signs indicating MI can include fatigue, weakness, nausea, vomiting, retrosternal chest pain, and loss of consciousness.

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Description

Test your knowledge on Acute Coronary Syndromes (ACS) and cardiac arrest with these flashcards. This quiz covers definitions, key differences between angina types, and related concepts for a comprehensive understanding of cardiovascular health.