Typical angina
3/3
- supsternal chest pain
- worse with exertion
- relieved with rest / NG
Atypical angina ( Angina equivalent )
2/3
- shortness of breath (dyspnea), diaphoresis (sweating), extreme fatigue, or pain at a site other than the chest, occurring in a patient at high cardiac risk
Medications that lowers mortality in ACS:
💊 Aspirin / DAPT
💊 Statins
💊 ß-blockers
💊 ACE-i
The most important preventable risk factor for CAD is […]
smoking 🚬
In the management of Stable angina
1. ECG : non specific ST / T wave changes
2. Troponin : normal
3. […]
Repeat troponin 6 hours after
medications for NSTEMI :
🔸 DAPT (Aspirin/Clopidogrel)
🔸 ß-blocker
🔸 ACE-i
🔸 Statins
🔸 Heparin
🔸Nitroglycerin
🔸 Morphine
🔸 GP iib/iiia inhibitors
What is the role of PCI and tPA in ACS
thrombolytics only for STEMI
▪️ PCI within first 90 min
▪️tPA if presented late or PCI fail
🔴 CABG: reserved for cardiogenic shock, Arrhythmias, Mechanical complications of MI
Contraindications of theombolytics:
- Coagulopathy / active bleeding
- recent surgery or trauma
- recent stroke
- Dissecting Aortic Aneurysm
Patient present with MI
Hypotensive and bradycardia
What is your first line management ?
Atropin
Patient present with MI
Was managed by PCI
On warfarin for AF
What is the best management regarding his anticoagulation therapy?
✔️ Continue warfarin
✔️ add DAPT
medications for STEMI :
🔸 DAPT (Aspirin/Clopidogrel)
🔸 ß-blocker
🔸 ACE-i
🔸 Statins
🔸 Heparin (only after tPA)
🔸Nitroglycerin
🔸 Morphine
🔸 thrombolytics (but PCI is superior)
