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Cardiovascular - Acute Coronary Syndromes PDB CEN Exam
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Cardiovascular - Acute Coronary Syndromes PDB CEN Exam...
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Cardiovascular - Acute Coronary SyndromesPDB CEN Exam
Stable Angina Pectoris
CP that occurs w/ physical exertion, short duration
**relieved by rest or NTG
- negative troponin
NSTEMI
Plaque rupture, absent ST elevation
- positive troponin
STEMI
ST elevation d/t obstruction of vessels w/ thrombosis
- positive troponin
Prinzmetal's Angina
AKA variant angina - ischemia d/t coronary vasospasms (usually stimulants)
- cyclical pain at rest
- vasospasm is precipitated by stress
ST elevation resolves and pain relief when vasospasm resolves*** BB may exacerbate
vasospasm d/t unopposed alpha stimulation
S/S of Acute coronary syndromes
Chest Tightness
Jaw/neck/left arm/epigastric pain
, scapular discomfort
N/V
S/sx of schock
dysrhythmias
diaphoresis
dizziness
**Women - increased fatigue, scapular, RUQ pain
**DM more likely to have silent MI
Labs A/w ACS
Troponin - elevation in 3-12 hours, peaks 10-24
CK-MB (myoglobin) - rises earlier but not specific
Signifant history for those in ACS emergency
Use of Phosphodiesterase inhibitors (sildenafil/viagra) w/in last 24 hrs
Cocaine - leaves unopposed alpha stimulation if given beta blockers
What is unopposed alpha stimulation
acute elevation in blood pressure and/or worsening coronary artery vasoconstriction
following the administration of a β-blocker
Limb Leads
Leads I, II, III, aVR, aVL, aVF are all derived using 3 electrodes - Right arm, left arm, left
leg
Contiguous Leads
Leads that view geographically similar areas of the myocardium; useful for localizing
areas of ischemia.
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