Cardiac Emergencies

Question 1

What is a cardiac emergency?

Answer 1

A sudden, life-threatening situation where normal heart function is disrupted, requiring immediate medical attention.

Question 2

What are common examples of cardiac emergencies?

Answer 2

Myocardial infarction, cardiac arrest, unstable angina, pulmonary embolism, aortic dissection, cardiac tamponade, sudden cardiac death, and lethal arrhythmias.

Question 3

What is the leading cause of cardiac emergencies?

Answer 3

Coronary artery disease and arrhythmias.

Question 4

What are the modifiable risk factors for cardiac emergencies?

Answer 4

High blood pressure, smoking, physical inactivity, obesity, diabetes, and an unhealthy diet.

Question 5

What are the non-modifiable risk factors for cardiac emergencies?

Answer 5

Age, gender, and genetic predisposition.

Question 6

What are the key components of managing a cardiac emergency?

Answer 6

Early recognition, CPR, defibrillation, and case-specific treatments.

Question 7

What is the first step in managing a suspected cardiac arrest?

Answer 7

Check for consciousness, pulse, and breathing; call emergency services if absent.

Question 8

What is the role of an Automated External Defibrillator (AED)?

Answer 8

To analyze heart rhythm and deliver an electric shock if necessary to restart the heart.

Question 9

What is the first-line treatment for ventricular fibrillation (VF)?

Answer 9

Immediate defibrillation followed by CPR.

Question 10

What is the purpose of coronary angioplasty in cardiac emergencies?

Answer 10

To open blocked coronary arteries and restore blood flow.

Question 11

What is the initial response to a cardiac arrest?

Answer 11

Call emergency services, perform CPR, and use an AED if available.

Question 12

What are the symptoms of a heart attack (myocardial infarction)?

Answer 12

Chest pain, shortness of breath, nausea, sweating, and pain radiating to the arm or jaw.

Question 13

What is the role of aspirin in a heart attack?

Answer 13

It reduces clot formation and improves blood flow to the heart.

Question 14

How is cardiac tamponade treated?

Answer 14

Emergency pericardiocentesis to drain excess fluid from the pericardium.

Question 15

What is the hallmark sign of aortic dissection?

Answer 15

Sudden, severe chest pain that radiates to the back.

Question 16

What is the recommended compression-to-breath ratio in CPR?

Answer 16

30 compressions to 2 breaths.

Question 17

How deep should chest compressions be during CPR?

Answer 17

At least 4-5 cm (1.5-2 inches) deep.

Question 18

What is the target compression rate for CPR?

Answer 18

100-120 compressions per minute.

Question 19

What is the primary function of an implantable cardioverter-defibrillator (ICD)?

Answer 19

To detect and correct life-threatening arrhythmias automatically.

Question 20

What is the most common cause of sudden cardiac death?

Answer 20

Ventricular fibrillation.

Question 21

What is the definitive treatment for complete heart block?

Answer 21

Pacemaker implantation.

Question 22

What is the first-line drug for bradyarrhythmias?

Answer 22

Atropine.

Question 23

What is the first-line treatment for pulseless electrical activity (PEA)?

Answer 23

High-quality CPR and identifying the underlying cause (H’s and T’s).

Question 24

What are the ‘H’s and ‘T’s of cardiac arrest?

Answer 24

Hypoxia, Hypovolemia, Hydrogen ion (acidosis), Hyper-/Hypokalemia, Hypothermia, Toxins, Tamponade, Tension pneumothorax, Thrombosis (coronary or pulmonary).

Question 25

What are the indications for advanced life support (ALS)?

Answer 25

Persistent cardiac arrest despite initial CPR and defibrillation.

Question 26

What is the first-line antiarrhythmic for refractory ventricular fibrillation?

Answer 26

Amiodarone.

Question 27

What is the role of epinephrine in cardiac arrest?

Answer 27

Increases coronary perfusion and enhances cardiac output.

Question 28

What is the recommended dose of epinephrine during cardiac arrest?

Answer 28

1 mg IV every 3-5 minutes.

Question 29

What is the best initial test for diagnosing myocardial infarction?

Answer 29

ECG.

Question 30

What are the ECG findings in ST-elevation myocardial infarction (STEMI)?

Answer 30

ST-segment elevation in two or more contiguous leads.

Question 31

What cardiac marker is most specific for myocardial infarction?

Answer 31

Troponin.

Question 32

What is the first-line treatment for unstable angina?

Answer 32

Aspirin, nitroglycerin, beta-blockers, and heparin.

Question 33

What is the recommended time window for percutaneous coronary intervention (PCI) in STEMI?

Answer 33

Within 90 minutes of first medical contact.

Question 34

What is the preferred thrombolytic agent for STEMI if PCI is not available?

Answer 34

Alteplase (tPA).

Question 35

What is the major contraindication for thrombolytic therapy?

Answer 35

Active bleeding, recent stroke, severe hypertension, or intracranial hemorrhage.

Question 36

What is the treatment for bradycardia with hemodynamic instability?

Answer 36

Atropine, followed by transcutaneous pacing if needed.

Question 37

What is the role of beta-blockers in acute coronary syndrome?

Answer 37

Reduces myocardial oxygen demand and prevents arrhythmias.

Question 38

What are the indications for coronary artery bypass grafting (CABG)?

Answer 38

Severe multi-vessel coronary artery disease or failed PCI.

Question 39

What is the first-line treatment for pulmonary embolism with hemodynamic instability?

Answer 39

Thrombolysis or surgical embolectomy.

Question 40

What is the classic ECG finding in pulmonary embolism?

Answer 40

S1Q3T3 pattern (deep S in lead I, Q wave in lead III, inverted T in lead III).

Question 41

What is the role of anticoagulation in pulmonary embolism?

Answer 41

Prevents clot propagation and recurrence.

Question 42

What is the most effective way to prevent cardiac emergencies?

Answer 42

Lifestyle modification: smoking cessation, diet, exercise, and blood pressure control.

Question 43

What is the role of implantable defibrillators in post-cardiac arrest patients?

Answer 43

Prevents recurrent sudden cardiac death in high-risk patients.

Question 44

What are the three types of cardiac arrest rhythms?

Answer 44

Ventricular fibrillation (VF), pulseless ventricular tachycardia (pVT), and asystole/PEA.

Question 45

What is the immediate treatment for asystole?

Answer 45

High-quality CPR and epinephrine; defibrillation is not indicated.

Question 46

What is the survival rate for out-of-hospital cardiac arrest with early defibrillation?

Answer 46

Increases to over 50% if performed within minutes.

Question 47

What are the key predictors of good outcomes in cardiac emergencies?

Answer 47

Early bystander CPR, early defibrillation, and advanced life support.

Question 48

What is the target post-resuscitation oxygen saturation?

Answer 48

94-98% to avoid hyperoxia injury.

Question 49

What is the role of targeted temperature management (TTM) after cardiac arrest?

Answer 49

Reduces neurological damage in comatose survivors of cardiac arrest.

Question 50

What lifestyle modifications reduce the risk of recurrent cardiac emergencies?

Answer 50

Healthy diet, regular exercise, smoking cessation, and blood pressure control.

Question 51

What is the first-line medication for hypertensive emergency?

Answer 51

IV nitroprusside or labetalol, depending on the cause.