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Pathology | Physician Assistant (PA) School Study Aid
Stable Angina
- Assessment
- Chest Pain with Exertion
- Relieved within 15 Minutes
- ST Depression
- Interventions
- Nitroglycerin
- Up to 3 Doses q 5 Minutes
- Rest
- Antiplatelet Medication
- CABG
- Angioplasty
2 mins
Unstable Angina
- Assessment
- Chest Pain with Rest or Exertion
- Limits ADLs
- > 15 Minutes
- Less Likely Relieved by Nitroglycerin
- ST Depression
- Fatigue
- Considerations
- Acute Coronary Syndrome (ACS) Treatment
- Emergency Treatment
2 mins
Myocardial Infarction Assessment
- Assessment
- Substernal Chest Pain
- Crushing or Dull Sensation
- Arm, Jaw, and Neck
- > 20 Minutes
- Unrelieved by Nitro
- Palpitations
- Diaphoresis
- Fear of Impending Doom
- Nausea and Vomiting
- Shortness of Breath
- Considerations
- Monitor for Arrhythmias
2 mins
Myocardial Infarction Diagnosis
- Diagnosis
- 12 Lead ECG
- ST Elevation
- Q Wave
- T Wave Inversion
- Troponin T and I
- CK-MB
- Considerations
- Early ECG
- Cardiac Stress Test
2 mins
Myocardial Infarction Interventions
- MONA
- Morphine
- Oxygen
- Nitrates
- Aspirin
- Thrombolytics (tPA)
- Invasive Procedures
- Cardiac Catheterization
- Stent Placement
- Angioplasty
- Coronary Artery Bypass Grafting (CABG)
- Considerations
- Decrease Modifiable Risk Factors
- Resuming Activity (Physical, Sexual)
2 mins
Cardiac Catheterization
- Considerations
- Fluttering Sensation
- Contrast Media
- NPO 6-12 Hours
- After Procedure
- Bed Rest
- Assess Circulation
- Assess for Bleeding
- Monitor Vital Signs
2 mins
Cardiac Enzyme Evaluation: Troponin
- Measures
- Cardiac Muscle Injury
- Time Ranges
- Detection in Blood: 4 Hours
- Peak: 24 - 36 Hours
- Return to Normal: 5 - 14 Days
- Considerations
- Most Specific for Cardiac Muscle
- Treat Aggressively
2 mins
Cardiac Enzyme Evaluation: Creatine Kinase CK-MB
- Measures
- Skeletal or Cardiac Muscle Injury
- Time Ranges
- Onset: 4-8 Hours
- Peak: 12-24 Hours
- Return to Normal: 2-3 Days
1 min
Cardiac Enzyme Evaluation: Myoglobin
- Measures
- Skeletal or Cardiac Muscle Injury
- Time Ranges
- Onset: 1 - 4 Hours
- Peak: 12 Hours
- Return to Normal: 24 Hours
- Considerations
- Elevation After 24 Hours: Reinfarction
2 mins
TIMI Score (Thrombolysis In Myocardial Infarction)
- Use
- Mortality Predictor
- Unstable Angina or NSTEMI
- 2 Week Risk of Death and Ischemic Events
- AMERICA (Each is +1)
- Age Greater or Equal to 65
- Markers Elevated
- EKG ST Changes (Greater or Equal to 0.5mm)
- Risk Factors for CAD (Coronary Artery Disease)
- Ischemia (2 Anginal Events in 24 Hours)
- Coronary Artery Disease (CAD)
- Aspirin Use in the Last 7 Days
3 mins
Evolution of Myocardial Infarction and Complications
- Hours to Days
- Arrhythmia
- Before 7 Days
- Fibrinous Pericarditis
- Papillary Muscle Rupture
- Interventricular Septum Rupture
- Before 14 Days
- Ventricular Pseudoaneurysm
- Ventricular Free Wall Rupture
- After 14 Days
- True Ventricular Aneurysm
- Dressler Syndrome
- Other
- Left Ventricular Failure
2 mins
12 Lead Contiguous Leads - Anterior Wall MI
- Leads Elevated
- Lead V3
- Lead V4
- Artery Affected
- Left Anterior Descending (LAD)
56 secs
12 Lead Contiguous Leads - Septal Wall MI
- Elevated Leads
- Lead V1
- Lead V2
- Artery Affected
- Left Anterior Descending (LAD)
48 secs
12 Lead Contiguous Leads - Inferior Wall MI
- Leads Elevated
- Lead II
- Lead III
- Lead aVF
- Artery Affected
- Right Coronary Artery (RCA)
56 secs
12 Lead Contiguous Leads - Lateral Wall MI
- Leads Elevated
- Lead I
- Lead aVL
- Lead V5
- Lead V6
- Artery Affected
- Circumflex
1 min
Brugada Syndrome
- Defective Myocardial Sodium Channels
- Predominance in Asian Males
- Autosomal Dominant
- Pseudo-Right Bundle Branch Block Pattern
- Persistent ST Elevations in Leads V1-V2
- Risk of VTACH and Sudden Cardiac Death
- Syncope
- Management
- ICD
- Antiarrhythmics
3 mins
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