ACS and AMI - Presentation, Investigation and Treatment

Question 1

What is an acute coronary syndrome?

Answer 1

Any sudden cardiac event suspected or proven to be related to a problem with the coronary arteries

Question 2

What is a myocardial infarction?

Answer 2

Cell death in the myocardium due to ischaemia - can be major due to a complete coronary artery occlusion or minor due to a partial/transient coronary artery conclusion

Question 3

What can be seen on an ECG of someone with complete coronary occlusion?

Answer 3

Initially - ST elevation

At 3 days - Q waves

Question 4

What can be seen on an ECG of someone with partial coronary occlusion?

Answer 4

Initially - No ST elevation

After 3 days - No Q waves

Question 5

What condition is a chronic ischaemic heart disease?

Answer 5

Stable angina

Question 6

What syndromes are acute coronary syndromes?

Answer 6

Unstable angina and STEMI.NSTEMIs

Question 7

Would a transmural MI have ST elevation and a Q wave on an ECG?

Answer 7

Yes

Question 8

Would a subendocardial MI have ST elevation and a Q wave on an ECG?

Answer 8

No

Question 9

What evidence is needed to diagnose an MI?

Answer 9

A positive cardiac biomarkers test and one of the following:
Symptoms of ischaemia, new ECG changes, evidence of coronary problem on coronary angiogram/autopsy or evidence of new cardiac damage on another test

Question 10

What are the non-cardiac causes of troponin rise?

Answer 10

Pulmonary embolism, sepsis, renal failure and sub-arachnoid haemorrhage