Acute coronary syndrome

Question 1

Diagnosis of MI

Answer 1

Detection of cell death with biomarker(tropin1) and one of:
symptoms of ischaemia
new ECG changes
evidence of coronary problem on coronary angiogram or autopsy
evidence of new cardiac damage on another test

Question 2

non MI causes of tropin increase

Answer 2

Arrhythmia
Pulmonary embolism
Cardiac contusion
Sepsis
Anaemia

Question 3

ST elevation suggests worse or better prognosis

Answer 3

worse

Question 4

MI symptoms

Answer 4

May radiate to left arm and/or neck

less of a pain may be described as a discomfort

Question 5

What must you check on examination

Answer 5

HR and bp in both arms

Question 6

Key investigations

Answer 6

ECG
Blood test (tropin)

Question 7

total occlusion to coronary artery causes what to ST segment

Answer 7

evaluation

Question 8

partial occlusion to coronary artery causes what to ST segment

Answer 8

ST depression and loss of Q waves after 3 days

Question 9

What type of MI may be missed on normal ECG

Answer 9

Posterior MI as ECG chest leads are on the front

Question 10

Best treatment for STEMI

Answer 10

Stent or PCI

Question 11

other treatment for STEMI

Answer 11

Thrombolysis

Question 12

When wouldn’t you give thrombolysis

Answer 12

recent stroke or history of intercranial bleed

severe hypertension/on warfarin/recent surgery

Question 13

Treatment for NSTEMI

Answer 13

GTN and opioids