NSER 7210 - Module 3 Already Rated A+
Apply a systematic approach to patients with chest pain and acute coronary syndromes ️C - Check
pulse = CPR, Crash cart with pads
A - AVPU, Airway Patent, suction, airways
B - WOB, SOB, O2 sat - O2 if <90%
C - ED handshake, skin, IV, Tele, ECG
...
Describe the typical signs/symptoms of an esophageal rupture ✔️Vomiting followed by severe chest
pain, SOB and subcu emphysema, and rapid circulatory collapse
Describe the typical signs/symptoms of a pneumothorax ✔️Pain (Sudden and pleuritic) and SOB,
absence of breath sounds
Tension pneumo - deviated trachea way from collapsed lung
Describe the typical signs/symptoms of acute pericarditis ✔️Chest pain that may radiate to the back,
neck or shoulders that is worse with inspiration, improved while sitting up or leaning forward
Dyspnea
, ECG changes: concave ST segment elevation, T wave inversions or PR segment depression that are
present in many leads (not contiguous leads)
Describe stable angina ✔️AKA demand ischemia. Chest pain triggered by stress or exertion. Resolves
with rest +/- nitro.
No ECG or biomarker changes, no injury to heart tissue
Describe unstable angina ✔️Blood flow through a coronary artery is partially or intermittently blocked.
Symptoms: Symptoms occur and linger at rest
Myocardial ischemia occurs, but no injury.
ECG may show T-wave inversion or ST depression
No change in biomarkers
Describe an NSTEMI ✔️Blockage of a coronary artery with collateral circulation in tact, or a blockage in
microcirculation.
Symptoms occur at rest
ECG may show T-wave inversion or ST depression
Biomarkers elevated as tissue injury occurs
Describe a STEMI ✔️Complete blockage of a coronary artery causing tissue ischemia and injury, if not
resolved = cell death
ECG - ST segment elevated in at least 2 contiguous leads
Biomarkers elevated
Describe the 2 reperfusion strategies for coronary artery blockage ✔️1. PCI - Percutaneous coronary
intervention - A catheter is used to open the blocked or narrowed artery
2. Fibrinolytics - Converts plasminogen to plasmin which breaks down fibrinogen and fibrin clots
State the coronary artery involved in an Septal MI ✔️LAD
Leads: V1 and 2
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