Acute coronary syndrome
include unstable angina , STEMI , NSTEMI .
cardiac enzymes slevated in STEMI , NSTEMI
signs :
1) typical chest pain more in duration >20mn
2) N , V , sweeting
diagnosis :
1) cardiac enzymes .
a) myoglobin : 1st enzyme to appear 1-4 hrs and first to disappear 24 hrs ( best to recurrence )
b) troponin-I : the best , rise in 3-12hrs and return to normal in 7 days .
c) CK-MB : rise in 3-12 hrs and return in 2-3 days
d) LDH : last one appear and last one disappear .
2) ECG : show ST elevation in STEMI and ST depression in NSTEMI .
treatment : MONA-B + anticouagulate +emergency reperfusion therapy ( PCI and stenting the best or fibrinolytic )
morphine
O2
nitrate
aspirin
B-blockers
cardiac enzymes slevated in STEMI , NSTEMI
signs :
1) typical chest pain more in duration >20mn
2) N , V , sweeting
diagnosis :
1) cardiac enzymes .
a) myoglobin : 1st enzyme to appear 1-4 hrs and first to disappear 24 hrs ( best to recurrence )
b) troponin-I : the best , rise in 3-12hrs and return to normal in 7 days .
c) CK-MB : rise in 3-12 hrs and return in 2-3 days
d) LDH : last one appear and last one disappear .
2) ECG : show ST elevation in STEMI and ST depression in NSTEMI .
treatment : MONA-B + anticouagulate +emergency reperfusion therapy ( PCI and stenting the best or fibrinolytic )
morphine
O2
nitrate
aspirin
B-blockers
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