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Acute Coronary Syndrome Notes

This is a sample of our (approximately) 4 page long Acute Coronary Syndrome notes, which we sell as part of the Cardiology Notes collection, a MBChB (hons) (1st) package written at University Of Leicester in 2014 that contains (approximately) 27 pages of notes across 8 different documents.

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Acute Coronary Syndrome Revision

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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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