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Coronary Artery (Spectrum of CP (Demand Ischemia: Lower O2 demand (ASx…

- - - - brings on Px: + w/ exertion
        
        Relieves: rest
        
        Biomark: NA
        
        ST seg changes: NA
        
        % occlusion: ~70%
    - - brings on Px: + @ rest
        
        Relieves: nothing!
        
        Biomark: no damage NA
        
        ST seg changes: NA
        
        % occlusion: ~90%
    - - brings on Px: + @ rest
        
        Relieves: nothing
        
        Biomark: elevated
        
        ST seg changes
        
        % occlusion: almost complete
    - - brings on Px: NA
        
        Relieves: NA
        
        Biomark:NA
        
        ST seg changes: NA
        
        % occlusion: <50%
      - :warning: Never stent Asx CAD
  - - - brings on Px: + @ rest
        
        Relieves: nothing
        
        Biomark: elevated
        
        ST seg changes: seg elevation
        
        % occlusion: 100
- - - - ok w/ ß blocker :trumpet: : prevent reflex tachy
    - - :warning:~~Beta Blockers :trumpet:~~ : if flash pulm edema or decompensated HF :broken_heart:
    - - send home with
        
        Long acting NG w/ ß blocker :trumpet: :persistent stable angina
        
        Short acting NG for limited time
- - - - :pencil2:Troponins peak first and LAST a while. Reinfarctions: use CK
      - :check:Troponins
      - :green_cross: This is Unstable angina
        
        Same CP w/ less exertion
        
        more CP w/ same amount of exertion
        
        Is this Coronary Ischemia? Get Stress Test #
        
        :check: Stress test (Elective Cath, schedule that appt w/ Cards)
        
        :pencil2: Why Cath Unstable angina?
        To see how many vessels involved
        
        3 vessel involvement or LAD: CABG (Sx :hocho:)
        
        2 vessels: Stent
- - - - Clopidogrel :baseball::cricket_bat_and_ball:
        
        Heparin :fox_face: :bear:
- - - - PEx
        
        Non-pleuritic CP:
        
        doesn't hurt breathing
        
        Non-Positional:
        
        no relief on position
        
        Non-tender:
        
        non reproducible w/ touch
      - When CP occurs:
        
        SOB
        
        presyncopal :sleeping:
        
        nausea/vomit
    - - Non-mod
        
        Family Hx :family:
        
        Age >45 :male_sign:
        >55 :female_sign:
- - - - At risk tissue :checkered_flag:
        
        dead tissue (scar)