Myocardial Infarction

Question 1

aVR, aVL, I, II, aVF, III limb leads all show depolarization of the heart in what plane?
V1-V6 precordial leads all show depolarization of the heart in what plane?

Answer 1

1) Frontal or coronal plane

2) Horizontal plane

Question 2

What does a normal axis look like?
What does a left axis deviation look like?
What does a right axis deviation look like?

Answer 2

1) Positive I and aVF leads
2) Positive I and negative aVF leads
3) Negative I and positive aVF leads

Question 3

If coronary arteries are partially occluded it is termed?

If coronary flow is occluded?

Answer 3

1) Unstable Angina or NSTEMI

2) STEMI

Question 4

Myocardial infarctions result in?

What part of ECG is abnormal?

Answer 4

1) Dead tissue, lack depolarization

2) Elongated Q waves

Question 5

Myocardial injury can result in?

What part of ECG is abnormal?

Answer 5

1) Deficient blood supply, unable to fully polarize

2) ST elevation

Question 6

Myocardial ischemia can result in?

What part of ECG is abnormal?

Answer 6

1) Deficient blood supply, impaired repolarization

2) Inverte, tall, peaked T waves

Question 7

What are cardiac biomarkers of necrosis?

Answer 7

1) Troponin I (cTnI)

2) Troponin T (cTnT)

Question 8

When are cardiac biomarkers detectable after onset AMI?
When do they peek?
How long can they persist?

Answer 8

1) 1-4 hours after
2) 10-24 hours
3) 5-14 days

Question 9

What can cause false positive cTnT?

Answer 9

Renal failure

Question 10

What is the presentation for NSTEMI?

Where is the damage located in the heart?

Answer 10

1) Elevated troponin, CK/MB but no ST segment elevation

2) Subendocardium

Question 11

What does a STEMI look like on ECG in men?

In women?

Answer 11

1) 2mm ST elevation in one lead with no LVH or 1 mm ST elevation in multiple leads
2) Same as men but even one 1.5 mm elevation counts

Question 12

When there is an anterior wall infarction, what artery is affected?
What leads are involved for anteroseptal?
What leads are involved for anteroapical?

Answer 12

1) Left anterior descending a.
2) V1-V2
3) V3-V4

Question 13

When there is an inferior wall infarction (RV), what artery is affected?
What leads are involved?

Answer 13

1) Right coronary a.

2) II, III, aVF

Question 14

When there is an lateral wall infarction, what artery is affected?
When there is an anterolateral wall infarction?
What leads are involved for lateral?
What leads are involved for anterolateral?

Answer 14

1) Circumflex artery
2) LAD or Circumflex a.
3) I, aVL
4) V5-V6

Question 15

When there is an posterior wall infarction, what artery is affected?
What leads are involved?

Answer 15

1) Posterior descending a.

2) V1-V3 (prominent R wave in V1, ST depression in V2/V3)

Question 16

If the P wave is present what type of rhythm is it?

If the P wave is absent?

Answer 16

1) Sinus

2) Afib

Question 17

What sign on the ECG can point to BBB?
What points to LBBB?
RBBB?

Answer 17

1) Wide QRS
2) QRS negative in V1
3) QRS positive in V1

Question 18

What does AV block look like on ECG?
Hypocalcemia?
Hypercalcemia?
Hyperkalemia?
Hypokalemia?

Answer 18

1) Long PR
2) Long QT
3) Short QT
4) T wave peaked
5) T wave flat (U wave)

Question 19

What does subendocardial ischemia look like?

What does transmural ischemia look like?

Answer 19

1) ST depression

2) ST elevation

Question 20

If a patient was admitted to the hospital 4 days ago for an acute MI, what biomarker is indicative of a new myocardial infarction?

Answer 20

CK-MB

Question 21

CK-MB is a more useful marker for recognizing?

Answer 21

Re-infarction following an acute MI

Question 22

Besides tropoinin and CK-MB, what labs may point to an MI?

Answer 22

1) CRP elevation
2) WBC elevation
3) BNP elevation