Myocardial Infarction

Question 0

Stable angina

Answer 0

a. Also called exertional angina
b. Occurs with activities that involve exertion or emotional stress; relieved with rest or nitroglycerin
c. Usually has a stable pattern of onset, duration, severity, and relieving factors

Question 1

Angina

Answer 1

1. Angina is chest pain resulting from myocardial ischemia caused by inadequate myocardial blood and oxygen supply.
2. Angina is caused by an imbalance between oxygen supply and demand.
3. Causes include obstruction of coronary blood flow resulting from atherosclerosis, coronary artery spasm, or conditions increasing myocardial oxygen consumption.

Question 2

Unstable angina

Answer 2

a. Also called preinfarction angina
b. Occurs with an unpredictable degree of exertion or emotion and increases in occurrence, duration, and severity over time
c. Pain may not be relieved with nitroglycerin.

Question 3

Myocardial infarction

Answer 3

1. Myocardial infarction occurs when myocardial tissue is abruptly and severely deprived of oxygen.
2. Ischemia can lead to necrosis of myocardial tissue if blood flow is not restored.
3. Infarction does not occur instantly but evolves over several hours.

Question 4

Risks for MI

Answer 4

1. Atherosclerosis
2. Coronary artery disease
3. Elevated cholesterol levels
4. Smoking
5. Hypertension
6. Obesity
7. Physical inactivity
8. Impaired glucose tolerance
9. Stress

Question 5

Troponin level

Answer 5

a. Level rises within 3 hours.

b. Level remains elevated for up to 7 to 10 days.

Question 6

Total creatine kinase level

Answer 6

a. Level rises within 6 hours after the onset of chest pain.

b. Level peaks within 18 hours after damage and death of cardiac tissue.

Question 7

CK-MB isoenzyme

Answer 7

a. Peak elevation occurs 18 hours after the onset of chest pain.
b. Level returns to normal 48 to 72 hours later.

Question 8

STEMI

Answer 8

Electrocardiogram shows ST elevation MI (STEMI)

Question 9

MONA

Answer 9

Morphine
Oxygen
Nitroglycerin
Aspirin

Question 10

What is CABG

Answer 10

Remove donor artery and place between aorta and coronary artery distal to the blockage.

Question 11

How long after ischemia does cel death occur?

Answer 11

4-12 hours. Irreversible damage after 12 hours.

Question 12

ECG changes with a NSTEMI

Answer 12

Persistent ST wave depression

T wave inversions.

Question 13

Dopamine (inotropin)

Answer 13

Increases heart rate, contractility, CO, systolic BP,