Biomarkers causesstdepressiontwaveinversionor

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Unformatted text preview: sels or extensive collaterals­ subendocardial infarct Activation of primarily the platelet aggregation system Causes the formation of a platelet rich clot The “white” clot Differentiate fr STEMI w. biomarkers Causes ST depression ,T wave inversion or nonspecific ST changes on the ECG Clinical Presentation Clinical Severe retrosternal chest pain at rest or on exertion, radiates to shoulder, jaw or neck and lasts longer than 20­ 30 minutes Feeling of ‘impending doom’ Associated with nausea, vomiting, dyspnea and diaphoresis May occasionally cause primarily epigastric pain Not relieved by nitroglycerin Differentials Differentials Aortic dissection Acute pulmonary embolism Pneumothorax Pericarditis Costochondritis GERD/PUD/ oesophageal spasm Management Management 50% die before reaching hospital Check the ABC’s Check vital signs Do a 12 lead ECG and repeat as necessary Routine chemistry, cardiac enzymes, clotting factors, CBC, lipid levels Complete Blood Count??? Administer supplemental oxygen Administer aspirin­chewed 160­325 mg Administer analgesics e.g. Morphine, NTG ECG with STEMI ECG with STEMI Diagnosis Diagnosis Clinical symptoms of chest pain syndrome Typical ECG changes Positive cardiac biomarkers­ Troponin I, Troponin T, CK­MB ,CPK, AST, LDH CK-MB = creatine kinase in cardiac (MM skeletal, Bb brain) , CPK = creatine phospho...
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