Acute coronary symptoms

Question 1

complete obstruction MI =

Answer 1

STEMI

Question 2

major differing factor along acute coronary syndrome continuum

Answer 2

ST elevation (STEMI) vs not (NSTEMI, UA)

Question 3

presentation unstable angina

Answer 3

acceleration of ischemic symptoms (frequency, intensity, duration)

angina at rest

no relief by usual dose of Nitro

Question 4

sypathetic effect of MI

parasymph

Answer 4

symph: cold clammy skin diaphoresis
parasympth: nausea, vomting,

Question 5

cardiac findings of MI

Answer 5

S4 (+S3 is systolic dysfxn) gallop

dyskinetic bulge (ant wall MI)

systolic murmur (if mitral regurg. or VSD)

Question 6

ECG abnormalities UA/NSTEMI

Answer 6

ST depression and or T wave inversion

tranient with chest pain(UA)

persist (NSTEMI)

Question 7

STEMI ECG progression

Answer 7

ST elevation

Hours: ST elevation, reduced R, Qwave

Day1-2 Twave inversion

Days: Normalizes ST, T inversion

Weeks: Q wave persists
(S STarteRs Take Normal Questions

Question 8

serum markers of infarction in NSTEMI and STEMI

Answer 8

cardiac troponins

Creatine Kinase (CK-MB)

Question 9

beginning, peak for Serum MI markers

Cardiac troponins

CK-MB

Answer 9

cTn rise 3-4h, peak 18-36hr

**CK-MB **rise 3-8 hours, peak 24hr

Question 10

serum biomarkers for UA

Answer 10

none

Question 11

treatment difference STEMI vs non

Answer 11

STEMI have total occlusion and benefit from immediate reperfusion therapies

Question 12

treatment high/low risk STEMI

Answer 12

low - fibrinolytic therapy (If PCI not available)

high - Primary PCI

Question 13

treatment NSTEMI low/high risk

Answer 13

Low - conservative, cath lab only if reccurent angina or stress test positive

high - cath lab > PCI or CABG

Question 14

most important factor in post MI recovery+outcome

Answer 14

extend of LV dysfunction

Question 15

standard post MI therapy

Answer 15

aspirin

beta block

HMG-CoA inhibitor

ACE inhibitor (if LV dysfunction)