ARTEROSCLEROSIS
ARTEROSCLEROSIS
ARTEROSCLEROSIS
Endothelial damage
CK 96 4–6 h 2–3 d ++ ++
Cardiac Biomarkers
• Positive Cardiac Markers
• cTnI>0.1, CK-MB>5, CK> 266
• CK, CK-MB every 8h x3d
• cTnI X1 (at least 3h after the onset of chest discomfort)
• CTnI
• cTnI begins to increase 3h after ischaemia, peaks at 14-18h and remains
elevated for 5-7days
• cTnI levels 1.0-1.6: About 1/3 of patients previously diagnosed as unstable
angina because of normal CK-MB levels actually have elevated cTnI levels and
therefore are experiencing a micro MI
APPROACH TO A PATIENT WITH
SUSPECTED ACS
Immediate General Treatment
• O2
• Aspirin 300mg
• Nitroglycerin (0.4mg SL or spray)
• Morphine (if pain not relieved by NTG)
(Memory MONA)
Bed rest
Nursing
• Telemetry Monitoring
• HR every 2h and rhythm every 4h or as patient condition warrants
• O2
• O2 sat every 4h. Delivery via nasal prongs for 2-3h. Continue if low arterial sat (<90%)
• Activity level
• Bedrest with commode privileges for 12 h
• If haemodynamically stable progress activity as tolerated with ambulation to the bathroom, bathing,
and light ambulation
• A patient with an uncomplicated Mi is likely to return to prior activities within 2 weeks
READING ASSIGMENT
• Atrial Fibrillation
• Infective Endocarditis
• Deep Vein Thrombosis