18. Cardiopulmonary MI

Question 1

What does STEMI mean?

Answer 1

ST elevation myocardial infarction

Question 2

What does NSTEMI mean?

Answer 2

non ST elevation myocardial infarction

Question 3

One of Six adults in the US die from coronary heart disease. One coronary event occurs every 30 seconds. What percent of MIs do STEMIs account for?

Answer 3

30%

Question 4

What are the most common cardinal symptoms of cardiovascular disease? (5)

Answer 4

Chest pain
Dyspnea, orthopnea, wheezing
Cough/Blood in cough
Fatigue/Weakness
Pain in extremities

Question 5

What is lavine sign?

Answer 5

Person makes a fist and holds it against the middle of their chest

Question 6

The most common cause of MIs is atherosclerosis. If coronary flow is occluded completely it is STEMI, if partially occluded then NSTEMI or UA. What is atherosclerosis?

Answer 6

Plaque builds up, shoulder of cap breaks off plaque and causes thrombus in coronary artery

Question 7

What are the top 4 history/clinical manifestations associated with MIs?

Answer 7

1. Chest discomfort
2. Heavy pressure
3. Pain left side
4. Nausea, vomitting

Question 8

NSTEMI will have ECG with ST segment ______ and T wave ________
chest pain adn ELEVATED cardiac enzymes

Answer 8

ST segment depression

T wave inversion

Question 9

NSTE ACS (non ST elevated acute coronary syndrome) Will have an ECG with ST segment \_\_\_\_\_\_\_ and T wave \_\_\_\_\_\_
** Chest pain and NORMAL cardiac enzymes**

Answer 9

ST depression

T wave inversion

Question 10

Ischemic patterns (deficient blood supply and impaired repolarization) are associated with?

Answer 10

Inverted T waves and tall peaked T waves

Question 11

Injury patterns (deficient blood supply and inability to repolarize) are associated with?

Answer 11

ST segment elevation

Question 12

Necrosis patterns or infarctions (dead tissue, lacks depolarization) are associated with?

Answer 12

Q wave wide and long

Question 13

The left anterior descending artery (LAD) will be occluded in an anterior wall infarction seen in which leads?

Answer 13

V1-V6 (v1-v4)

Question 14

The right coronary artery will be occluded in an inferior wall infarction or RV infarction seen by which leads?

Answer 14

Inf: II, III, AVF
RV: V3R-V6R

Question 15

The circumflex artery will be occluded in a lateral wall infarcation and can be seen using which leads?

Answer 15

I, AVL, V5-V6

Question 16

The posterior descending artery will be occluded in a posterior wall infarction and can be seen with which leads?

Answer 16

V1-V3

Question 17

In the zone of ischemia, the T wave will be ________ and the reciprical effects on the opposite side will be?

Answer 17

T wave will be inverted

Reciprical will have inverted QS and high upright T wave

Question 18

In the zone of injury, the ST segment will be _______ and the reciprical effects on the opposite side will be?

Answer 18

ST segment will be elevated

Reciprocal will have depressed ST, upright T wave

Question 19

In the zone of necorsis, the Q wave will be _________ and the reciprocal effects will be?

Answer 19

Q wave ( d/t absence of depolarization) large wide, deep (with ST and T wave abnormalities)
Reciprocal will have upright T wave, depressed ST, wide R

Question 20

What occurs during recovery of an MI?

Answer 20

ST segment is first to go back to normal, and then T wave. Q will NEVER go back to normal

Question 21

For a true posterior infarct, what will be seen?

Answer 21

Reciprocal changes in Anterior leads

V1V2 prominent R wave and upright T wave and ST segment depression (RECIPROCAL)

Question 22

An increase in BNP can mean what?

Answer 22

Increased ventricular wall stress and fluid overload

Question 23

If there is an increase in BNP, CRP, WBC, troponin I or T(cTnT). what can be assumed?

Answer 23

ELEVATED enzymes = NSTEMI

Normal enzymes = NSTE ACS