Low probability ACS

Question 1

examination findings that make ACS more likely (8)

Answer 1

signs of cardiac failure such as 
1 hypotension, 
2 diaphoresis, 
3 pulmonary rales, 
4 jugular venous distention, 
5 new mitral regurgitation, 
6 bradycardia, 
7 tachycardia, 
8 S3 cardiac gallop

Question 2

Absolute Contraindications to Exercise Testing (8)

Answer 2

1 Acute myocardial infarction (within 2 d)
2 High-risk unstable angina
3 Uncontrolled cardiac dysrhythmias causing symptoms or hemodynamic compromise
4 Symptomatic severe aortic stenosis
5 Uncontrolled symptomatic heart failure
6 Acute pulmonary embolus or pulmonary infarction
7 Acute myocarditis or pericarditis
8 Acute aortic dissection

Question 3

Relative Contraindications to Exercise Testing

Answer 3

1 Left main coronary stenosis
2 Moderate stenotic valvular heart disease
3 Electrolyte abnormalities
4Severe arterial hypertension (>200 mm Hg systolic, >110 mm Hg diastolic)
5 Tachydysrhythmias or bradydysrhythmias
6 Hypertrophic cardiomyopathy and other forms of outflow tract obstruction
7 Mental or physical impairment leading to inability to exercise adequately
8 High-degree atrioventricular block

Question 4

….. is the most sensitive biomarker for cocaine-associated MI.

Answer 4

Cardiac troponin

Question 5

…,…. AND …. are the mainstays of therapy for chest pain in cocaine-associated MI. …. are contraindicated.

Answer 5

Aspirin, nitrates, and benzodiazepines

beta -blockers

Question 6

Patients with cocaine-associated STEMI are best managed with …..

Answer 6

percutaneous coronary intervention