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BLT- Acute Coronary Syndromes
Transcript of BLT- Acute Coronary Syndromes
STEMI UA NSTEMI Reduction in coronary blood flow Clinical features History Examiation Chest pain S.O.C.R.A.T.E.S. Onset Characteristic Radiation Site Associations Timing Exacerbating and relieving factors Severity Initial Mx ECG! Assess likelihood
Define context 1. Support diagnosis
2. Exclude differentials
3. Identify complications MONA MOVE Monitor
ECG Morphine (antiemetic)
Aspirin Within 10 minutes
Determines management STEMI NSTE-ACS Needs URGENT reperfusion Time is muscle Primary Percutaneous Coronary Intervention Thrombolysis if not available Up to 12 hours post onset Follow local protocols Admit to acute care Aspirin
Statin Monitoring Risk stratify Review High risk Intermediate/low risk Cardiac enzymes Review If pain not settling NSTEMI Unstable angina GTN infusion
?early ACEi STOP thrombosis REDUCE myocardial O2 demand Thanks Stevan Wing Acute coronary syndrome A practical approach Some coronary anatomy... Complications of myocardial infarction 1. Have a system
2. Know the most common Davies, Thomas
Heart 1985 Reimer, Lowe,
Circulation 1977 Many thanks Prof. Timmis Many thanks Prof. Timmis Many thanks Prof. Timmis Many thanks Prof. Timmis http://bit.ly/Dr-Wing-ACS