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Acute Coronary Syndrome (ACS)

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leading cause of death in US LCA supplies RCA supplies

ACS left circumflex LAD (widow maker) right side of heart inferior aspect of left ventricle -> posterior descending AV conduction system imbalance between oxygen supply & demand atherosclerotic disease -> reduction of myocardial blood flow predictiable relieved by rest/nitro usu < 10 minutes usu resolves w/ 2-5 min of rest or nitro EKG, done & read w/in 10 minutes ischemia/infarction highly supportive of AMI indicates larger infarct pattern I, aVL, V5, V6 lateral leads II, III, aVF Inferior V3, V4 anterior V1, V2 septal to help find other causes of chest pain screen for possible aortic dissection -widened mediastinum -contraindiaction to thrombolytics morphine oxygen nitro ASA

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ischemia usual caus eof ischemia stable angina is angina time frames single best initial test ST depression in leqads distant from the leads suggest

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lateral leads I, aVL, V5, V6 inferior leads II, III, aVF anterior V3, V4 septal V1, V2 portable CXR can be used

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MONA