Acute coronary syndromes- EXSC 462 3

ACS

occurs when there are blockages in one or more coronary arteries

angina

chest pain

myocardial infraction will occur

if vessel occlusion >60 mins resulting in necrosis

Fibrous cap ruptures

leads to a blood clot

Clincial considerations

history of symptoms. dyspnea, systolic hypotension, diaohoresis, sinus tachycardia, and tachypnea

Tests

ECG, chest radiograph, and biomarkers

ECG looks for

ST elevation or ST depression (ischemia)

Chest radiograph looks for

hemodynamic instability

Biomarkers look for

CTn, ANP, and creatine kinase

complications of acute myocardial infarction

arrhythmias, new mitral valve regurgitation, conduction abnormalities, infarct extension/expansion, and myocardial rupture

at least two of the following three variables must occur to be diagnosed

chest pain for >30 minutes, ECG showing ST segment or T wave changes, and prescense of biomarkers of myocyte necrosis

reperfusion therapy

PCI and CABG

PCI

inflate balloon in artery and place metal stent widening the artery, quicker recovery time

CABG

a open heart surgery, stitch a graft where the blockage was, a longer recovery time, 3-4 weeks

Exercise is NOT a

treatment for ACS becuase the damage is already done BUT it can decrease inflammation and other advantages towards health

Highest intensity must be at least

10 bpm below the HR or 1 MET known to causes chest pain

resistance training

avoid the valsalva maneuver, use intensity below ischemic threshold

what is the instigating factor that eventually causes an ACS event

endothelial injury