Summary
Acute coronary syndrome summary
- Course
- Institution
Summary of acute coronary syndromes including STEMI, NSTEMI and unstable angina. Notes on symptoms, investigations and management.
[Show more]
Seller
Follow
surveygeorgechen
Content preview
ACSSuspect ACS when: chest pain more than 15 minutes, N+V, sweating, breathlessness, haemodynamic
instability, pain occurs without exertion. DO NOT use response to GTN to confirm or exclude diagnosis.
Normal ECG does not exclude ACS.
Initial management
M: morphine (+IV metoclopramide/cyclizine)
O: oxygen if sats below 94%
N: GTN
A: aspirin 300 mg then 75 mg OD
C: clopidogrel 300 mg then 75 mg OD
All ACS can be given PCI if haemodynamically unstable
Plus, start: secondary prevention atorvastatin 80 mg ON, beta blocker bisoprolol 2.5 mg OD, LMWH
fondaparinux (can also start ACEI)
Long term management
Beta blocker for 12 months – reduces myocardial demand
ACEI – prevents cardiac remodelling
GTN spray PRN
Aspirin (lifelong), clopidogrel (12 months), statin
BP control, lifestyle modifications (Mediterranean diet, exercise, smoking cessation)
Symptoms
Central crushing chest pain
Occurs several times a day with increasing severity
Can occur at rest (unstable angina)
Radiation to jaw, arm or neck
Dyspnoea and tachycardia
Nausea and sweating
Unstable angina
NO ST elevation on ECG with negative cardiac markers
Risk factors: female, older age > 50, family history, personal history of CAD, hypertension, diabetes,
hyperlipidaemia, obesity, smoking
Differentials
o Stable angina – pain occurs only by exertion and is relieved by GTN or rest
o STEMI – ECG ST elevation
o NSTEMI – raised cardiac markers
Diagnostic investigation is CT coronary angiography
NSTEMI
Acute ischaemic event. NO ST elevation on ECG with positive cardiac markers. Men and women present
differently. Men typical chest pain lasting several minutes. Women middle/upper back pain with dyspnoea.
Risk factors: increasing age, previous CAD, smoking, diabetes, obesity, dyslipidaemia
Investigations
o ECG
o Cardiac biomarkers
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller surveygeorgechen. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $4.50. You're not tied to anything after your purchase.
Can Stuvia be trusted?
4.6 stars on Google & Trustpilot (+1000 reviews)
72042 documents were sold in the last 30 days
Founded in 2010, the go-to place to buy study notes for 14 years now
Recently viewed by you
