ACS

Question 1

Anterior MI

ST Elevations leads?

Answer 1

V1-V6

Left Anterior Descending

Question 2

V7, V8, V9

ST Elevations

Answer 2

Posterior MI

Right Coronary Artery or
Left Circumflex

Question 3

Septal MI

ST Elevations leads?

Answer 3

V1-V3

Left Anterior Descending

Question 4

V1, V4R

ST Elevations

Answer 4

Right Ventricular MI

Right Coronary Artery

Question 5

Inferior MI

ST Elevations leads?

Answer 5

II, III, aVF

Reciprocal ST-depressions: I, aVL

Question 6

I, aVL, V5, V6

ST Elevations

Answer 6

Lateral MI

Left Circumflex

Question 7

Lateral MI

ST Elevations leads?

Answer 7

I, aVL, V5, V6

Reciprocal ST-depressions: II, II, aVF

Question 8

V1-V6

ST Elevations

Answer 8

Anterior MI- Left Anterior Descending

Question 9

Posterior MI

ST Elevations leads?

Answer 9

V7, V8, V9

Reciprocal ST-depressions V1-V3

Question 10

V1-V3

ST Elevations

Answer 10

Septal MI

Left Anterior Descending

Question 11

CK-MB return to baseline?

Answer 11

48-72 hours

Question 12

limb leads

Answer 12

(high lateral: I, aVL; inferior: II, III, aVF)

Question 13

precordial leads

Answer 13

anterior: V1, V2, V3; lateral: V4, V5, V6

Question 14

For a ST-elevation MI (STEMI) look for what on ECG?

Answer 14

ST-elevations of 1 mm or more in two contiguous limb leads

or

2 mm elevations in the precordial leads

Question 15

MI rx?

Answer 15

Remember the following mantras:

IV O2 monitor!”

MONA greets all patients at the door

Question 16

MONA stands for?

Answer 16

morphine, oxygen, nitroglycerin and aspirin. Beta-blockers should be used to control the heart rate and blood pressure.

Question 17

Left bundle branch block (LBBB) ECG findings

Answer 17

QRS duration > 1 20 msec

no R wave in V1; wide, tall R waves in I, V5, and V6

Question 18

Right bundle branch block (RBBB) ECG findings

Answer 18

QRS duration > 1 20 msec; RSR’ complex (“rabbit ears”); wide R wave in V1
wide S wave in I, V5, and V6

Question 19

TIMI Risk Score for UA/NSTEMI factors

Answer 19

65 or older?
 3+ CAD risk factors?
Known CAD?
Aspirin use in past week?
Severe angina?
ST segment changes?
Positive cardiac markers?

1 point each
5+ = high risk