Acute Coronary Syndrome

Question 1

Define acute coronary syndrome.

Answer 1

An array of symptoms deriving from myocardial ischemia

Question 2

Describe the pathology of a STEMI.

Answer 2

Complete coronary occlusion with myocardial necrosis

Question 3

Describe the pathology of an NSTEMI.

Answer 3

Partial coronary occlusion with myocardial necrosis

Question 4

What is the usefulness of CK-MB?

Answer 4

It rises in response to myocardial infarction, like troponin, but it returns to normal much faster, so it can be helpful in identifying secondary heart attacks.

Question 5

Unstable angina can present as pain at rest or __________.

Answer 5

pain with decreased exertion

Question 6

__________ is not on the spectrum of acute coronary syndrome.

Answer 6

Stable angina

Question 7

What are the two possible treatments for STEMI?

Answer 7

If the patient can be catheterized within 90 minutes, then catheterize them, and if they cannot then administer fibrinolytics.

Question 8

How should NSTEMIs and unstable angina be treated?

Answer 8

In those conditions, the vessel is not completely occluded. As such, administer anti-coagulant and anti-platelet agents.

Question 9

What three things does the endothelium secrete that are anti-thrombotic?

Answer 9

Prostacyclin, nitric oxide, and antithrombin

Question 10

Subendocardial injuries are most often due to ___________.

Answer 10

partial occlusions

Question 11

Although useful as an indicator of timing, CK-MB is not as ___________.

Answer 11

specific to cardiac myocardium as troponin I and T

Question 12

Troponin I and T peak at ___________.

Answer 12

18-36 hours

Question 13

The main difference between an NSTEMI and unstable angina is _________.

Answer 13

presence of biomarkers (in NSTEMI)

Question 14

Those with NSTEMIs and UA should be given ____________.

Answer 14

aspirin, another antiplatelet drug, and heparin