Acute coronary syndromes/ IHD

Question 1

Indications for cardiac catheterization

ASYMPTOMATIC or SYMPTOMATIC

Answer 1

High risk
SCD
Sustained Monomorphic VTach
Non sustained Polymorphic VTach

Question 2

Indications for cardiac catheterization

SYMPATOMATIC

Answer 2

CHF II III IV or stable angina
ACS (UA and NSTEMI)
Chest pain syndrome of unclear etiology

Question 3

Indications for cardiac catheterization

STEMI

Answer 3

_ cardiogenic shock

mechanical complications

Question 4

Contraindication to CCB in Mi

Answer 4

Pulmonary edema

Evidence of LV dysfunction

Question 5

CI for beta blockers

Answer 5

PR interval >24
2 or 3 degree AV block
HR <60
SBP <90
Shock
LV failure 
Severe reactive airway disease

Question 6

Reversible plot inhibitor

Answer 6

Yicagrelor

Question 7

Target heart rate B blockade

Answer 7

50-60

Question 8

Criteria for AMI

Answer 8

Rise of cardiac biomarkers values
With s and s of ischemia
New ST changes with new LBBB
Devi of pathologic w waves

Question 9

Killips classification

Answer 9

Class I no signs of congestion 0-5
Class II mod HF 10-20
Class III severe HF, pulmonary edema 35-45%
Class IV shock with systolic pressure <90
85-95%

Question 10

ICD after stem I

Answer 10

40 days after stemi

No spontaneous VT or VF 48h after stemi

Question 11

Time reversible damage to the mYocardium

Answer 11

<20 min

Question 12

T wave inversion

Answer 12

Transmural ischemia

Question 13

What is a positive ischemic response TMST

Answer 13

> 0.1 mV ST segment depression lasting longer than0.08 S

Question 14

Important signs of LV dysfunction on cardiac catheterization

Answer 14

Reduced EF

Elevated LvEDP

Question 15

False positive TMST

Answer 15

Asymptomatic men < 40
Digitalis and anti arrhythmic agents 
IVCD
Abnormal serum postassium
Ventricular hypertrophy
Resting ST segment abnormalities

Question 16

This trial found that an early invasive strategy conferred 40% reduction in recurrent cardiac events in patients with elevated cTn level

Answer 16

TACTICS-

TIMI 18

Question 17

What are the temporal stages of STEMI

Answer 17

1) acute few hours-7 days
2) healing 7-28 days
3) healed >29 days

Question 18

Levels of cTnI and cTnT may remain elevated for ____ days after STEMI

Answer 18

7-10 days

Question 19

CK trend inSTEMI

Answer 19

Rises within 4-8 hrs and returns to normal by 48-72 h