CanadiEM Podcasts: CRACKCast, ClerkCast, CarmsCast, First Year Diaries CRACKCast E078 - ACS Part B
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May 18, 2017 Dive into the world of acute coronary syndromes where experts break down critical criteria like Sgarbossa for diagnosing AMI and uncover the complexities of Takotsubo cardiomyopathy. Explore the kinetics of cardiac biomarkers like Troponins and learn the ins and outs of PCI versus thrombolytics. Discover the importance of timely interventions and the nuances of managing NSTEMI patients. Plus, gain insights on unique cases like cocaine-induced ACS and the role of cutting-edge tools such as the HEART score!
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Sgarbossa Criteria for LBBB STEMI
- The Sgarbossa criteria help identify acute MI in patients with pre-existing left bundle branch block (LBBB).
- Key findings are concordant ST elevation, ST depression in V1-V3, and excessive discordant ST elevation.
Takotsubo Cardiomyopathy Basics
- Takotsubo cardiomyopathy, or 'broken heart syndrome,' mimics ST elevation MI but lacks coronary obstruction.
- It typically affects postmenopausal women after emotional stress and causes apical ballooning of the left ventricle.
Cardiac Biomarker Kinetics
- Troponins rise within 2 hours after symptom onset and remain elevated for days, being highly sensitive for MI.
- CK-MB rises quicker but is less specific, so troponin is preferred for diagnosis.