ACS

Question 1

may or may not have ST depression and/or T wave inversion
on ECG (ischemic changes)

Answer 1

Unstable Angina (UA) and non-ST elevation MI

Question 2

chest pain (new onset) occurring at rest, increasing in
frequency and duration, lasts 10 minutes or longer, not
relieved by change in activity/rest, not relieved after taking nitroglyercin

Answer 2

Unstable Angina (UA) and non-ST elevation MI

Question 3

Cardiac enzymes will be normal/ negative for

Answer 3

unstable angina

Question 4

Cardiac enzymes will be positive for

Answer 4

non stemi

Question 5

If took 1 nitro and has to take another one what do you do

Answer 5

call 911 before taking second one

Question 6

Pts with Unstable Angina (UA) and non-ST elevation MI must get cardiac cath within

Answer 6

12-72 hours

Question 7

> 1 mm or more above isoelectric line in at least 2 contiguous leads [V2 or V3 must be > 2mm or more] (in leads facing the area MI)

Answer 7

ST elevation

Question 8

ST elevation indicates

Answer 8

myocardial injury and if not treated will evolve into
permanent necrosis of myocardium

Question 9

Cardiac biomarkers are elevated with

Answer 9

STEMI

Question 10

Emergency STEMI first thing

Answer 10

percutaneous coronary intervention (PCI) – nonsurgical procedure used to treat blockages in ACS. Places stent in artery.

Question 11

Emergency STEMI second thing

Answer 11

thrombolytic therapy (Most common TPA, will burst the clot)
- If the hospital doesn’t have a PCI, they will give TPA for the time being.

Question 12

Cant give tPA if

Answer 12

if they have a recent hemorrhage, head injury, recent surgery, stroke of any type, or uncontrolled hypertension.

Question 13

Pain, Diaphoresis, increased HR and BP, skin: ashen, clammy, and/or cool to touch,Hypotension, decreased urine output, Crackles, Jugular vein distention, hepatic engorgement, peripheral edema, Abnormal heart sounds may be distant, S3 or S4, new murmur (may be holosystolic), n/v, Fever - up to 100.4 F in first 24 to 48 hours, up to 4-5 days

Answer 13

MI clinical manifestations

Question 14

a. neck, shoulder blade, jaw pain, and abdominal pain
b. extreme fatigue
c. weakness
d. shortness of breath
e. possible sleep disorders
f. light-headedness

Answer 14

atypical presentation of MI

Question 15

If pt is having a STEMI get them to cath lab within _____ and receive thrombollytic therapy within _____ if no PCI is available

Answer 15

90 mins; 30 mins

Question 16

Thrombolytic therapy for STEMI Inclusion criteria

Answer 16

chest pain < 12 hours with ECGS changes of
STEMI, no absolute contraindication

Question 17

Thrombolytic therapy for STEMI Absolute contraindications

Answer 17

Severe uncontrolled hypertension,
Active internal bleeding, history of ICH, intracranial or spinal surgery within 2 mon, recent ischemic stroke (within past 3 mon), significant closed head injury or facial trauma within past 3mo, suspected aortic dissection