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ACS
Question | Answer |
---|---|
partial occlusion of coronary artery | unstable angina or non-st-segment-elevation MI (NSTEMI) |
total occlusion of coronary artery | ST segment elevation MI (STEMI) |
clinical manifestations of unstable angina | new in onset, occurs at rest, increase in frequency, duration or less effort, pain lasting > 10 mins, needs immediate treatment |
clinical manifestations of MI | result of abrupt stoppage of blood flow through a coronary artery, causing irreversible myocardial cell death |
STEMI | occlusive thrombosis, EMERGENCY, artery must be opened within 90 minutes, PCI is preferred treatment |
NSTEMI | nonocclusive thrombus - does not cause ST elevation, may undergo PCI within 12-72 hours, no thrombolytic therapy |
Assessment of MI | chest pain (not relieved by nitro, rest, or position changes), nausea and vomiting, fever, catecholamine release and stimulation of SNS, cardiac (increased HR and bp at first then drop, crackles, jvd, abnormal heart sounds) |
MI diagnosis | s/s, 12 lead EKG, elevated cardiac enzymes, elevated serum troponin I and T, elevated myoglobin |
MI pharmacological management | M-morphine sulfate (not getting relief from nitro) O-oxygen N-nitrates A-aspirin |
thrombolytic therapy | only indicated for patients with STEMI, used on patients who present to facilities without PCI capabilities, monitor for bleeding, have a 30 minute window |
CABG complications | bleeding, impaired contractility, low CO, pericardial tamponade, respiratory insufficiency, pain, emboli/stroke, dysrhythmias |