Acute Coronary Syndrome

Question 1

Give 3 causes of raised troponin

Answer 1

Myocarditis
Acute coronary syndrome
Aortic dissection
Anaemia
Chronic Kidney Disease
Heart failure
Pulmonary Embolism

Question 2

Which serum biomarker is an indicator of prognosis in ACS?

Answer 2

Troponin levels

Question 3

Name 2 advantages of using troponin instead of other cardiac biomarkers

Answer 3

More specific to cardiac muscle

More long-lasting

Question 4

What drugs reduce mortality and improve prognosis post-MI

Answer 4

B-blockers

Statins

Question 5

What investigation should be done on a patient post-MI?

Answer 5

Echocardiogram

Question 6

4 complications of STEMI

Answer 6

Ventricular septal defect
Ventricular wall rupture
Papillary muscle rupture i.e mitral regurgitation
Acute heart failure
Dressler’s Syndrome
Arrhythmias
Ventricular aneurysm (persistent ST segment elevation)

Question 7

Give 4 indications for PCI

Answer 7

ST elevation > 1mm in limb leads
ST elevation > 2mm in chest leads
New LBBB
Posterior STEMI

Question 8

2 contraindications to thrombolysis

Answer 8

Recent surgery
Active bleeding
Previous haemorrhagic stroke
Recent trauma
GI bleed < 1 month ago
AV malformation

Question 9

Give 2 dynamic ECG changes in an MI

Answer 9

Pathological Q waves

T wave inversion

Question 10

Which cardiac marker rises first post-MI?

Answer 10

Myoglobin

Question 11

Which cardiac marker is best to use to test for reinfarction?

Answer 11

Creatinine-Kinase MB