Acute coronary syndromes

Question 1

central mechanism of ACS is

Answer 1

a ruptured plaque

Question 2

which type of plaques to ruptures occur?

Answer 2

in soft plaques with thin caps

Question 3

when platelets are exposed to collagen they

Answer 3

are activated

form a thrombus and may have ischemia as a result

Question 4

A sudden change in the lumen of a plaque can lead to

Answer 4

unstable angina

Question 5

rapid necrosis of an entire region supplied by an occluded artery leads to

Answer 5

an MI

Question 6

most often an ST elevation will have

Answer 6

a Q-wave

Question 7

If you have chest pain for >20mins to hours it is suggestive of

Answer 7

an infarct

Question 8

If angina is new, accelerated, crescendo, rest, or post-MI

Answer 8

concern that it is unstable

Question 9

ECG findings of Normal, T inversion or ST depression are indicative of

Answer 9

Unstable angina or Non-STEMI

Question 10

ECG findings of ST elevation or LBBB

Answer 10

STEMI

Question 11

ST elevations in V1-V4 suggest

Answer 11

Anterior wall, LAD

Question 12

ST elevations in 2,3 and aVF

Answer 12

Inferior wall, RCA

Question 13

ST elevations in v5-v6

Answer 13

Lateral wall, Circumflex

Question 14

How long until cardiac enzymes are elevated in necrosis

Answer 14

4-6 hours

Question 15

main cardiac enzymes to measure

Answer 15

troponin T and I

CK-MB

Question 16

If you have UNSTABLE angina with abnormal troponin

Answer 16

suspect a Non-STEMI

Question 17

Peak and drop off of cardiac troponin if reperfusion occurs

Answer 17

within 1-2 days it will peak, and then drop

Question 18

High sensitivity troponin assay has

Answer 18

High sensitivity but Low specificity

Question 19

therapy for unstable angina

Answer 19

rest
O2
pain control - nitroglycerine and morphine

Question 20

Therapy that improves survival in unstable angina

Answer 20

• Heparin
• anti-platelet
• beta block
• statin/acei

Question 21

If you have an occluded artery, how long until 90% of the myocardium is infarcted

Answer 21

3 hours

Question 22

STEMI is

Answer 22

angina lasting for 30 mins to hours

Question 23

Mimics of MI

Answer 23

PE
Pericarditis
Aortic dissection

Question 24

Heparin is contraindicated in

Answer 24

pericarditis

aortic dissection

Question 25

ECG findings in an MI

Answer 25

elevation in 2 contiguous leads in the same territory

Question 26

a new LBBB is equivalent to

Answer 26

an ST elevation

Question 27

what is the main goal of treatment for STEMI?

Answer 27

REPERFUSION - thrombolytics

Question 28

Main types of reperfusion for STEMI

Answer 28

• coronary angio

- thrombolytic

Question 29

what determines post-MI prognosis

Answer 29

• Age and left ventricular function
• residual disease
• an arrythmia
• comorbid disease