STEMI

Question 1

What is a STEMI?

Answer 1

An ACS with ST-segment elevation or new-onset LBBB

Question 2

What ECG changes occur within hours?

Answer 2

Tall T waves, ST elevation, new LBBB

Question 3

What ECG changes occur within weeks?

Answer 3

T-wave inversion, pathological Q waves

Question 4

What investigation would you do first?

Answer 4

ECG

Question 5

What would you do if PCI isn’t available within 120 mins?

Answer 5

Fibrinolysis and then transfer to primary PCI centre

Question 6

What drugs do you give if the patient is receiving PCI?

Answer 6

Clopidogrel/prasugrel and aspirin

Question 7

What drugs do you give if the patient is receiving fibrinolysis?

Answer 7

Alteplase, ticagrelor and aspirin

Question 8

What pneumonic is used to remember post-MI complications?

Answer 8

DREAAD

Question 9

What does DREAAD stand for?

Answer 9

Death
Rupture if heart septum
Edema due to HF
Arrhythmias
Aneurysm
Dressler's syndrome (pericarditis)

Question 10

What pneumonic is used to remember secondary prevention of ACSs?

Answer 10

ACAB

Question 11

What does ACAB stand for?

Answer 11

ACEi
Clopidogrel
Aspirin and atorvastatin
Beta blocker