Acute Coronary Syndromes Flashcards
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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?

<p>Retrosternal chest pain is the correct answer.</p> Signup and view all the answers

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

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

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

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

What is one goal of therapy for patients with ACS?

<p>Relief of ischemic chest discomfort is the correct answer.</p> Signup and view all the answers

What is the recommended dose of aspirin if not contraindicated?

<p>162-325 mg</p> Signup and view all the answers

What are contraindications for nitroglycerins?

<p>Severe bradycardia, tachycardia, hypotension, phosphodiesterase inhibitors within the past 24-48 hours.</p> 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.

<p>right ventricular involvement; nitrates</p> Signup and view all the answers

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

<p>90 minutes after the first medical contact; fibrinolytics</p> Signup and view all the answers

What is the preferred reperfusion therapy for STEMI patients?

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

What is the initial drug therapy for ACS?

<p>Oxygen (if needed), aspirin, nitroglycerin, morphine (if needed)</p> Signup and view all the answers

What is PCI?

<p>PCI opens the blocked artery with a tiny balloon and then a stent is placed to maintain blood flow to the heart.</p> 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.

<p>Acute coronary syndromes (ACS)</p> Signup and view all the answers

What symptoms can indicate myocardial infarction?

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

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

<p>myocardial infarction</p> Signup and view all the answers

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

<p>10 minutes</p> Signup and view all the answers

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

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

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

<p>Nondiagnostic ST-segment changes</p> Signup and view all the answers

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

<p>Percutaneous coronary intervention (PCI) and fibrinolytic therapy.</p> 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?

<p>0.1 to 0.3 mg every 5 minutes</p> 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)?

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

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

<p>ST-segment depression, T wave inversion</p> 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.

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