6 Acute Coronary Emergencies Free Online FlashCards

What causes an acute coronary syndrome?

Acute coronary syndromes are urgent conditions caused by a sudden reduction in blood flow to the heart muscle, commonly after a coronary plaque erodes or ruptures and a clot forms.

What conditions make up the acute coronary syndrome spectrum?

The three clinical categories are STEMI, NSTEMI, and unstable angina. They are not guarantees of how completely a coronary artery is blocked.

What ECG pattern identifies STEMI, and what must not wait?

STEMI involves persistent ST elevation meeting lead-specific criteria or another acute-occlusion pattern. Assess for immediate reperfusion; an initially normal troponin does not justify waiting.

What distinguishes NSTEMI from STEMI?

NSTEMI is an acute myocardial infarction without persistent diagnostic ST elevation. It requires a rise or fall in troponin, with at least one value above the assay’s 99th-percentile limit, in an ischemic clinical context.

What defines unstable angina?

Unstable angina is new, worsening, or rest angina without an acute troponin pattern that meets myocardial infarction criteria.

Does an elevated troponin alone diagnose a heart attack?

A raised troponin indicates myocardial injury, but MI diagnosis also requires evidence of myocardial ischemia.

Which symptoms can suggest ACS without prominent chest pain?

Possible ACS symptoms include chest pressure, tightness, heaviness, or pain; shortness of breath, sweating, nausea, light-headedness, or unusual fatigue may occur even without prominent chest pain.

What is the appropriate response to suspected ACS?

Suspected ACS is an emergency: activate emergency medical services rather than having the person drive themselves.

When should the initial 12-lead ECG be obtained?

Obtain and interpret a 12-lead ECG within 10 minutes of first medical contact.

When should an ECG be repeated, and what can ST depression in V1–V3 suggest?

Repeat the ECG if symptoms persist, recur, or worsen, because ischemic changes can evolve. ST depression in V1–V3 may point to a posterior infarction.

When may troponin testing be repeated after a nondiagnostic result?

If the first troponin result is nondiagnostic, repeat testing according to the local assay pathway: commonly at 1–2 hours for high-sensitivity assays or 3–6 hours for conventional assays.

When is oxygen indicated in ACS?

Give oxygen for hypoxemia or respiratory distress, rather than routinely to every patient with ACS.