Condition Info - BotMed Application

ConditionName

Acute coronary syndrome

ConditionDescription

Symptoms

Heavy, dull, pressure/squeezing sensation
Substernal or epigastric pain with radiation to left shoulder
Nausea, vomiting
Diaphoresis, anxiety
Dizziness, lightheadedness, syncope
Pain may improve with nitroglycerin.

PhysicalFindings

ClinicalTests

ECG: nonspecific changes, ST-segment elevation/depression, T-wave inversions, Q waves 
Increased or normal troponin
TTE: hypokinesis, regional wall motion abnormalities
First – EKG
After normal EKG – stress test (look for ST depression)
Ideology unclear – stress test (80% of the max heart rate 220-years)
Enzymes – acute pain in an emergency department 
Irreversible stress test confirms the presence of dead tissue

LDL <100 for ACD (LDL<70 for DM);
BP: 140/90 (130/80 for DM);
HDL >40 (but not low mortality);
TGR <150;

RiskFactors

DM – main risk;
Smoking history;
HTN – most common risk (>140/90, DM >130/80);
Hyperlipidemia;
FH of premature CAD in first degree relatives f/m/s. male<55, female <65);
Sex (post menopause female has a same risk level with a male);
Stress;

IsRedFlag

IsNPLEX

Consequence

ProgressionFromCondition

Atherosclerotic;
Lack of O2 delivery to the heart;

TreatmentOptions

Exercises – best;
Less alcohol;
Increase F&V intake;
Reduce stress;
Stops smoking – best immediate benefit; 
Control blood sugar;
Reduce BP;
Lover LDL;
Lose weight;

Increase HDL:
Stop smoking;
Exercises;
Niacin;

PharmOptions

Statins;

WebLink

https://www.merckmanuals.com/en-ca/professional/cardiovascular-disorders/coronary-artery-disease/overview-of-acute-coronary-syndromes-acs