MI

Question 1

Acute STEMI- Eti

Answer 1

• Prolonged imbalance between supply and demand of O2 blood
• Total blockage of coronary perfusion
• Elderly, women may not experience chest pain

Question 2

Acute STEMI- Sx

Answer 2

Angina at rest, early morning

• Pain builds rapidly- substernal, neck, jaw
• Minimally responsie to nitroglycerin or morphine
• Diaphoresis, weakness, impending doom
• Cyanosis, decrease peripheral pulse
• Rales, murmurs

Question 3

Acute STEMI- Dx

Answer 3

• CK-MB & Troponin elevations
• ST segment elevation on EKG
• New Q waves

Question 4

Acute STEMI- Tx

Answer 4

• Immediate reperfusion within- Stenting 2 hrs
• thrombolysis within 3 hours
• Aspirin
• Nitroglycerin

Question 5

Angina Pectoris- Eti

Answer 5

• Ischemia due to atherosclerortic heart disease

- Metabolic disorders- hyperthyroid, anemia,

Question 6

Angina Pectoris- Sx

Answer 6

• Precipitated by activity, relief with rest- short duration
• tightness, squeezing, burning in chest- fist clench over mid chest
• Radiates to left shoulder, arms, jaw, back
• Relief with nitroglycerin

Question 7

Angina Pectoris- Dx

Answer 7

• Exercise EKG- downsloping ST segment

Question 8

Angina Pectoris- Tx

Answer 8

Nitroglycerin, long term beta blockers, platelet inhibitors, lifestyle modifications

Question 9

NSTEMI- Eti

Answer 9

• Non- ST segment elevation due to MI or ischmia
• Unstable supply of o2 blood due to block
• Partial thrombus/ lysis

Question 10

NSTEMI- Sx

Answer 10

• Substernal chest pain at rest or minimal exertion
• Possible to have no pain
• Dyspnea, nausea, diaphoresis, syncope

Question 11

NSTEMI- Dx

Answer 11

• CK-MB & Troponin I

- New Q waves, ST wave depression,

Question 12

NSTEMI- Tx

Answer 12

• Antiplatelet/ anticoagulant
• Nitroglycerin
• Beta-blockers
• Statins

Question 13

Unstable angina- Sx

Answer 13

Similar to NSTEMI- uncontrollable by patient

Question 14

Unstable angina- Dx

Answer 14

• Microchanges in cardiac biomarkers
• EKG changes, no biomarker changes- T wave inversion, ST depression
• If Troponin above lower limit = NSTEMI

Question 15

Unstable angina- Tx

Answer 15

• Aspirin, platelet inhibitors
• Beta blockers
• Nitroglycerin
  NO THROMBOLYTICS
• Cath

Question 16

Prinzmetal angina- Sx

Answer 16

• Early morning chest pain
• unremarkable cardiac exam
• ST elevation- disappears with nitroglycerin
• Normal labs