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PASS 611 Physical Diagnosis
Acute Coronary Syndrome
14
Science
Graduate
03/03/2011

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Cards

Term
What are the risk factors?
Definition
Smoking, Hypertension,DM, Dyslipidemia, Family history (event in first degree relative <55 male <65 female) Age >45 male >55 female Chronic Kidney Disease, sedentary Obese
Term
What signs or symptoms are needed to diagnose a stemi or nstemi?
Definition

At least 2 of the following:

Ischemic symptoms Diagnostic ECG changes Serum cardiac marker elevations

Term
What are you likely to see during unstable angina?
Definition
Non occlusive thrombus
Non specific ECG
Normal cardiac enzymes
Term
What are the details of a NSTEMI?
Definition
Occluding thrombus sufficient to cause tissue damage & mild myocardial necrosis
ST depression, T wave inversion on ECG
Elevated cardiac enzymes
Term
What are the details of STEMI?
Definition
Complete thrombus occlusion
ST elevations on ECG or new LBBB
Elevated cardiac enzymes
More severe symptoms
Term
How do the elderly, diabetics, and women usually present with acute coronary syndrome?
Definition
Elderly: Shortness of breath
Diabetics: Vague symptoms
Women: Complain of feeling fatigued
Term
What are some symptoms of ACS?
Definition
Chest pain
Shortness of breath
Nausea/Vomiting
Diaphoresis
Weakness
Syncope
Term
What are the cardiac care goals?
Definition
Decrease the amount of myocardial necrosis
Preserve LV function
Prevent major adverse cardiac events
Treat life threatening complications
Term
What is the medical therapy for a STEMI?
Definition
MONA + BAH
Morphine, O2, Nitroglycerin, Asprin
Beta blockers, Ace-inhibitors, Heparin
Term
What is some additional medication for a STEMI?
Definition
Thienopyridine
Glycoprotein IIb/IIIa inhibitors
Aldosterone blockers
Term
Secondary prevention of a STEMI is what types of things?
Definition
Disease - HTN, DM, HLP: get them undercontrol
Behavioral: smoking, diet, PA, weight
Cognitive: education, cardiac rehab program
Term
What is the BP goal for prevention of STEMIs, how about one that is also diabetic or has chronic kidney disease?
Definition
<140/90
<130/80 in DM/CKD
Term
What is the goal for LDL and TG to prevent STEMIs?
Definition
LDL <100 (70)
TG <200
Term
For prevention of STEMIs, what is the goal for A1c?
Definition
<7 (6.5)
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