453: Test 2 ACS and MI

Leading cause of death in the US?
Most common type of cardiovascular disease?

______________ (CRP) – marker of inflammation. Chronically elevated CRP associated with unstable plaques. _________ often given to these patients

Goals for Ideal CV Health for Adults 20 years and older

Pathophysiology ACS specific to OCCLUSION

Pathophysiology ACS specific to VASOSPASM

Management of ACS

Managment of ACS
STEMI vs NSTEMI

ACS time frame:
Door to needle____
Door to ballon____

What should be administer for a patient with chest pain after a history and focus physical exam?

Acute Coronary Syndrome:
work up includes completed H&P, Trop I, CK MB, EKG

what do these findings indicate:
No ST-segment elevation
Neg Markers

Acute Coronary Syndrome:
work up includes completed H&P, Trop I, CK MB, EKG

what do these findings indicate:
No ST-segment elevation
Pos Markers

Acute Coronary Syndrome:
work up includes completed H&P, Trop I, CK MB, EKG

what do these findings indicate:
ST-segment elevation
Pos Markers

Difference between how men and women present with ACS/MI

women

What in the heck differentiates stable and unstable angina??

Difference between how men and women present with ACS/MI

Men

What’s the Evidence for Women with ACS?

Tx of MI in ED

Patient History and
Physical Exam with ACS/MI

The million other things chest pain could be besides an MI
(reference not memorization)

EKG and MI

ST DEPRESSION tend to imply

ST ELEVATION tends to imply

Anterior STEMI results from occlusion of the ________________

Anterior myocardial infarction CARRIES THE ______ PROGNOSIS of all infarct locations, mostly due to larger infarct size.

ST SEGMENT ELEVATION IN THE ______LEADS AND THE ________ LEADS

__________MI account for 40-50% of AMIs
USUALLY OCCURRING IN THE________

Inferior MI ST ELEVATION IN LEADS_________

Pharm management in MI
first medication priority and why

Pharm management of MI and why

Considerations with pharm management in a MI patient

Cardiac Markers:
________ is the preferred biomarker!

HOW TO PROPERLY MONITOR TROPONIN

OTHER CAUSES OF ELEVATED TROPONINS

Other cardiac markers:
What are they? What do they measure?

What is BNP?
WHAT DOES IT TRIGGER?

KEY COMPONENTS OF RELIABLE EVIDENCE BASED ACUTE MI CARE
(7 steps)

If a patient has 2 sets of negative cardiac enzymes and no significant ECG changes he/she will be sent for some form of direct evaluation of the heart

What will this include?

OBJECTIVES OF EXERCISE STRESS TESTS

LIMITATIONS OF THE EXERCISE STRESS TEST

What would make us want to immediately stop a stress test?

When to use a chemical stress tests?

Pharmacologic Stress Test:
Uses___________,___________, or____________ which:

If the stress test is positive then the patient will be sent for a ________ _______ where direct visualization of the______ arteries can be done. If significant occlusions are noted, they are opened with______ and possible stent placement whenever possible

stable vs unstable angina