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Title: Acute Coronary Syndrome
Description: these are notes summarized from Kaplan, step 2 first aid, and master the boards 2
Description: these are notes summarized from Kaplan, step 2 first aid, and master the boards 2
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Acute Coronary syndrome
ACS is: unstable angina, nonSTEMI, and STEMI
there is no physical exam that can tell these apart
ACS means we have ischemic chest pain but not sure if there is infarction
Unstable Angina:
patient presents with chest pain of acute onset
or progressive stable angina
here toponin is -ve (<0
...
05
ST depression, T wave inversion, or normal EKG
no EKG changes
STEMI:
chest pain with +ve troponin
ST elevations in 2 consecutive leads
or ST depressions in posterior leads that showed ST elevations on back EKG
the most common cause of death after MI is arrhythmia that’s why they should
be put on a monitor and defibrillator nearby (don’t give lidocaine as prophylaxis)
TREATMENT:
they are all treated the same way however if STEMI we have to go for
immediate Angioplasty (within 90mins) PCI (percutaneous coronary
intervention)
...
platelet plaques get stabilized by fibrin
2
...
plasmin is made of plasminogen
4
...
factor 13 stabilizes the clot and after this stabilization plasmin
can’t chop the fibrin off anymore since it becomes preserved
6
...
hence TPA has to be given before 12 hours since it only
works on a fresh clot
B blockers
Title: Acute Coronary Syndrome
Description: these are notes summarized from Kaplan, step 2 first aid, and master the boards 2
Description: these are notes summarized from Kaplan, step 2 first aid, and master the boards 2