ECCO

Question 1

If Chest pain lasts longer than ____ it may signal a greater likelihood of what?

Answer 1

*20 Minutes
*Infarction

Question 2

ACS has a ____ onset with pain starting where? Where can the pain radiate to?

Answer 2

*Sudden
*Precordial or substernal
*Arm, jaw, shoulders or back

Question 3

Stable angina can typically relieved with ____ and _____.

Answer 3

*Rest
*Nitro

Question 4

Hypoxia, edema, crackles, dyspnea, low CO are assessment findings that may indicate?

Answer 4

Heart failure

Question 5

Hypoxia, hypotension, Decreased U/O, cold clammy skin, diminished pulses, dyspnea are assessment findings that may indicate?

Answer 5

cardiogenic shock

Question 6

Palpitations w/or w/o hemodynamic compromise are assessment findings known as?

Answer 6

Dysrhthmias

Question 7

St Segment depression and T-wave inversion are produced by _____. What may this turn into?

Answer 7

*ischemia
*ST elevation (injury)

Question 8

Symmetrical precordial Twave inversion of 1-2mm more strongly suggests what?

Answer 8

Acute ischemia

Question 9

ST depression of 0.5 mm (1/2 small box) that is seen on ECG tracing that is seen with symptoms and resolves when patient is asymptomatic is highly indicative of what?

Answer 9

Severe CAD

Question 10

which leads could show a posterior MI? What 3 parts of the wave will show this and what will they look like?

Answer 10

*V1-V3 and/or V4
*Tall R waves, ST depression, Upright T-wave

Question 11

Anterior Wall MI would affect which 2 leads? Which vessels are involved?

Answer 11

*V3 and V4
*LAD and diagonal branch of LAD

Question 12

Septal Wall MI would affect which 2 leads? Which vessels involved?

Answer 12

*V1 and V2
*Septal branch of LAD

Question 13

Lateral Wall MI would affect which 4 leads? Which vessels involved?

Answer 13

*l, aVL, V5 and V6
*Left circumflex

Question 14

Inferior Wall MI would affect which 3 leads? Which vessels involved?

Answer 14

*ll,lll,aVF
*RCA

Question 15

Posterior VWall MI would affect which range of leads? Which kind of changes only? Which vessels involved?

Answer 15

*V1-V4
*Reciprocal changes only
*posterior descending branch

Question 16

Normal CK range total for Male?

Answer 16

55-170 units

Question 17

Normal CK range total for female?

Answer 17

30-135

Question 18

Normal CK-MB?

Answer 18

*Less than 10 or Less than 3% of total CK

Question 19

Normal Cardiac troponin i.

Answer 19

less than 0.03

Question 20

Normal Cardiac troponin t.

Answer 20

less than 0.2

Question 21

Biomarkers during MI will continue to rise for how long? What if they rise after that?

Answer 21

*24 hours
*Report to provider, could signify additional infarction

Question 22

Insufficient preload decreases what? What will happen as a result?

Answer 22

*Decrease stroke volume
*Increase heart rate to maintain cardiac output

Question 23

NTG causes ____. This reduces what three things? What dose is started and how often do you increase? This should not be administered within 24 hours of what type of meds? high vs Low doses?

Answer 23

*Vasodilation (primarily used for chest pain relief)
*Afterload, preload, Oxygen demand
*Start at 5mcg per min and increase by 5 mcg ever 3 to 5 minutes
*PDE-5 inhibitors (viagra, cialis)
*Low affects venous dilation and preload, High (Above 150) affects arterial dilation and afterload

Question 24

Phenylephrine or Neosynephrine will cause what? What happens to afterload? What does this not increase?

Answer 24

*Vasoconstriction
*Increases afterload and BP
*Does not increase HR

Question 25

Dopamine is a precursor for what? What is considered a low dose of dopamine and what does it do?

Answer 25

*Norepi and Epi
*2-10 mcg/kg/min
* increases contractility and HR, leading to increased cardiac output.

Question 26

What is considered a higher dose of dopamine and what does it do? What is this contraindicated in and why?

Answer 26

*10-20mcg/kg/min
*Increase in SVR and afterload
*Contraindicated in ACS because increases o2 demand

Question 27

What kind of medication is dobutamine? What 3 things does it do? What is it used in?

Answer 27

*inotrope
*vasodilation properties, increases contractility, decreases afterload without increasing HR
*Used in CARDIOGENIC SHOCK and decompensated HF

Question 28

Milirinone is similar to what drug? Increases ____ and deceases ___/____ without increasing____

Answer 28

*Dobutamine
*Increases contractility and decreases pre/afterload without increasing HR

Question 29

What does Nitropusside do? What are the results? When might this be used?

Answer 29

*Dilates both arteries and veins
*Results in reduction of preload and afterload
*Might be used in cardiogenic shock to place balloon pump