Acute Coronary Syndrome

Question 1

Angina occuring at rest and usually >20 mins

Answer 1

Rest angina

Question 2

PE findings w high likelihood of ACS

Answer 2

Transient mitral regurgitaion murmur, hypotension, diaphoresis, pulmonary edema & rales

Question 3

ECG findings w high likelihood of ACS

Answer 3

Angina at rest w ST elevation >0.5 mm
New onset BBB
Sustained ventricular tachycardia

Question 4

In patients w suspected ACS, ECG should be done within __ mins

Answer 4

10

Question 5

True posterior MI ECG findings

Answer 5

Initial R waves in V1 & v2 >0.04s nad R/S ratio >1;

R sided ECG shows 0.5 mm ST elevation in V7-V9

Question 6

RV MI ECG findings

Answer 6

ST elevations in II, III, aVF & ST segment depression in lateral leads; ST elevation in RV leads V3R & V6R

Question 7

Preexisting LBBB, MI can be reflected in ECG findings of:

Answer 7

Concordant

Question 8

Avoid _____ within 24-48 hrs in patients taking PDE inhibitors.

Answer 8

Nitrates

Question 9

Absolute contraindications in fibrinolytic tx in STEMI

Answer 9

Any prior ICH
Known structural cerebral vascular lesion (e.g. AVF)
Known intracranial neoplasm
Ischemic stroke within 3 mos
Active internal bleeding (Excluding menses)
Suspected aortic dissection or pericarditis