2536- Week 2: Cardiac system
CAD definition
narrowing of the arteries due to atherscelerosis
Myocardial Ischemia definition
when 75% of of the artery is occluded
Chronic Stable angina
reversible intermittent chest pain that usually occurs with certain activity and subsides when perciptating factor is removed
Myocardial infarction (MI)- Non-STEMI
less severe: partial occlusion caused by ruptured thrombosis
ECG FINDINGS
no ST elevation
CARDIAC BIOMARKERS
increased troponin and CK-MB
MANAGEMENT
no immediate reprefusion
PCI if high risk
Antiplatlets: ASA
Variants of stable angina
1) silent ischemia: usually asyptomatic and in diabetic pt
2) Nocturnal ischemia: occurs at night
3) Decubitis: only when lying down
4) Prinzmatel angina: response to spasm
Acute coronary syndrome (ACS) & Types
sudden BF blockage in CA
TYPES:
unstable angina
STEMI
Non-STMI
Unstable Angina
intermittent chest pain even at rest
can progress to an MI
Myocardial Infarction (MI)- STEMI
Emergent: complete occlusion
ECG FINDINGS
ST-elevation and prolonged Q wave
Cardiac Biomarkers
elevated CK-MB, troponin
TREATMENT
urgent PCI
Antianginal Drugs: Nitrates/Nitrites
short/ fast and long/slow acting kinds
Nitroglycerin is the most important for symptomatic treatment
Take up to 3 for 5 mins
burning sentation= potency
Antianginal drugs: Beta Blockers
Atenolol: indicated for prophylactic treatment
Metoprolol: perferred in acute cases
60 bts/min
Antianginal Drug: Calcium channel blocker
contraindicated to pt with degree blocks unless there is a pacemaker