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Acute Coronary Syndrome Notes

Medicine Notes > Cardiology Notes

This is an extract of our Acute Coronary Syndrome document, which we sell as part of our Cardiology Notes collection written by the top tier of University Of Leicester students.

The following is a more accessble plain text extract of the PDF sample above, taken from our Cardiology Notes. Due to the challenges of extracting text from PDFs, it will have odd formatting:

Acute Coronary Syndrome ACS = term covers
- Unstable angina
- NSTEMI
- STEMI

Similar underlying pathology of atherosclerosis, plaque rupture and thrombosis

Risk factors Non-modifiable o Smoking o Hypertension o Diabetes o Hyperlipidaemia o Obesity o Sedentary lifestyle

Modifiable o Age o Gender o Family history (1st degree relative < 55yrs)

Pathogenesis
- Myocardial ischaemia occurs when there is an imbalance between the supply of O2 + myocardial demand for it
- Coronary blood flow to a particular region of the heart may be reduced by o Mechanical obstruction e.g atheroma, thrombosis, spasm, embolus o Decreased flow of oxygenated blood e.g anaemia, hypotension
- Increased myocardial demand for O2 may be caused by o Increased cardiac output e.g thyrotoxicosis o Myocardial hypertrophy
- Myocardial ischaemia most commonly occurs from obstructive CAD in the form of coronary atherosclerosis Process of atherosclerosis Endothelial injury Result of mechanical stresses e.g hypertension Biochemical abnormalities e.g raised LDL, DM Immunological factos e.g free radicles from smoking Genetic alteration Accumulation of lipids and macrophages leads to foam cells Form the fatty streak Cytokine release causes further accumulation of macrophages
+ SMC migration and proliferation (A 50%
reduction in luminal diameter causeses sig. haemodynamic stenosis, therefore any increased in myocardial

= Plaque Plaque becomes unstable Rupture Thrombosis

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