42 Questions
What is the common pathophysiology of unstable angina (UA) and non-ST segment elevation myocardial infarction (NSTEMI)?
Atherosclerotic plaque rupture with subsequent platelet-rich thrombus overlying the culprit lesion
What differentiates unstable angina (UA) and non-ST segment elevation myocardial infarction (NSTEMI)?
The presence or absence of elevated cardiac biomarkers
What is the abbreviation for myocardial infarction with no obstructive coronary artery disease?
MINOCA
What is the abbreviation for ischaemia and no obstructive coronary artery disease?
INOCA
Which type of acute coronary syndrome is usually caused by an unstable atherosclerotic plaque rupture with subsequent platelet-rich thrombus overlying the culprit lesion?
Non-ST segment elevation myocardial infarction (NSTEMI)
What forms the group of acute coronary syndromes (ACS) usually caused by atherosclerotic disease?
Unstable angina (UA) and non-ST segment elevation myocardial infarction (NSTEMI)
Which of the following is NOT an advantage of LMWH over UFH?
Higher risk of allergic reactions
In the setting of NSTEACS, what is the documented benefit of thrombolytic therapy?
There is no documented benefit
Which condition is NOT considered a cause of increased myocardial metabolic demand?
Coronary occlusion
What characterizes a transmural myocardial infarction (MI)?
Ischemic necrosis extending from the endocardium through the myocardium to the epicardium
What is the leading cause of death in most industrialized nations throughout the world?
Myocardial infarction
What factor determines the severity of a myocardial infarction?
The size of the affected muscle segment
Which symptom is NOT commonly associated with a myocardial infarction?
Headache and dizziness
When are most cases of myocardial infarction clustered?
Around midnight or early morning
Which test is NOT required for the diagnosis of myocardial infarction?
Urinalysis
What is the normal range for Troponin I levels in blood?
0.0- 0.4 ng/ml
What should not delay the reperfusion strategy/treatment during diagnosis of myocardial infarction?
Blood sampling for serum markers
What is indicated if a patient experiences syncope or near-syncope without other cause, associated with a chest pain?
Coronary angiography
What is the best alternative for measuring injury to the heart muscle if troponin is not available?
Creatine kinase muscle and brain subunits (CK-MB)
What is the latest generation of cardiac enzyme testing that allows for detection of very low levels of troponin?
High sensitivity troponin (hscTn)
What is considered the best and preferred for measuring injury to the heart muscle due to its greater sensitivity and specificity?
High sensitivity troponin (hscTn)
Which of the following is recommended for all patients without contraindications at an initial oral loading dose of 150-300 mg?
Aspirin
Which antiplatelet agent is recommended in addition to aspirin and maintained over 12 months unless there are contraindications or an excessive risk of bleeding?
Ticagrelor
Which antiplatelet agent is recommended in patients proceeding to interventional treatment?
Prasugrel
When should a glycoprotein IIb/IIIa antagonist be considered?
If there are complications at angioplasty
What should be assessed at least twice 3-6 hours apart?
Cardiac biomarkers
What indicates ischemic dysfunction of a papillary muscle or mitral apparatus?
Increased intensity of a preexisting murmur
What does a rise of Tn occur within after injury and peaks within 1-2 days?
2-3 hours
What indicates overt pulmonary edema according to the Killip Classification?
Cardiogenic shock
Which leads should be used if the standard leads are inconclusive on the electrocardiogram?
Right leads, posterior leads
What is the primary purpose of echocardiography in the context of acute myocardial infarction?
Detecting wall motion abnormalities
Which arrhythmia occurs most commonly during the early hours after myocardial infarction?
Sinus bradycardia
What is the recommended treatment for premature ventricular complexes in the peri-infarct period?
β-blockers
Which arrhythmia is associated with a higher infarct mortality when occurring in the peri-infarct period?
Atrial fibrillation
What percentage of myocardial infarction patients experience ventricular fibrillation without antecedent-warning arrhythmias?
50%
What is the incidence of ventricular tachycardia in cases of myocardial infarction?
20% to 40%
Which arrhythmia occurs in approximately 10-20% of patients after myocardial infarction and is usually transient?
Atrial fibrillation
In what percentage of myocardial infarction cases does new bundle branch block occur?
~15%
What is the most common cause of sinus tachycardia in the peri-infarct period?
Sympathetic stimulation
What is the impact of Wenkebach rhythm in the peri-infarct period on long-term prognosis?
It has no impact on long-term prognosis
What is the primary reason for premature atrial contractions in patients with myocardial infarction?
Atrial or sinus node ischemia
What is the recommended treatment for sustained ventricular tachycardia during the peri-infarct period?
Cardioversion
Learn about the administration of anticoagulants like UFH and LMWH, and the considerations for discontinuation after percutaneous coronary intervention. Understand the advantages and contraindications of LMWH, and the use of thrombolytic therapy.
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