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Cardiology: Acute Coronary syndrome - Coggle Diagram
Cardiology: Acute Coronary syndrome
Differentiating ACS types based on ECG findings
STEMI: ST elevation or new LBBB
NSTEMI: ST depression + TWI
Unstable angina: Normal/non specific changes
MI types
1: classic atherosclerotic plaque disruption
2: myocardial supply < demand
3: SCD dxed @ autopsy
4: a/w PCI
5: a/w CABG
Sx to ask about on hx
Chest pain
SOB
orthopnoea
PND
diaphoresis
sense of impending doom
LOC
palpitations
nausea
dizziness
swelling in legs
Risk factors
Male
HTN
personal hx
family hx
hyperlipidaemia
smoking
DM
obesity
dDx
pericarditis
viral prodrome
relieved by sitting forward
ST elevation
check WCC/CRP
myocarditis
viral prodrome
check temp, WCC, CRP
PE
ECG: sinus tachycardia +
S1Q3T3
MSK (costochondritis)
Reproducible on physical exam
aortic dissection
tearing sensation radiating to back (intrascapular)
Radio-radial delay
L-R arm BP difference (>20mmHg)
do CT aortogram
pneumonia/pleurisy
DES/GORD
GTN relieves DES
ECG leads
Anterior
V3+4
LAD
Septal
V1+2
LAD
Lateral
left circumflex
I, V5, V6, aVL
Inferior
II, III, aVF
RCA
Tx
Prevention
Load with DAPT when ACS suspected (aspirin with clopidogrel and ticagrelor)
if STEMI detected PC if <120 mins since sx onset, thrombolysis if >120mins
Analgesia (2.5mg Cyclomorph IV +/or IV paracetamol)
Complications
conversion to STEMI
Cardiac arrest + death
Dresslers syndrome
ventricular aneurysm
arrhythmias
heart failure