Anticoagulant Administration in PCI
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Questions and Answers

What is the common pathophysiology of unstable angina (UA) and non-ST segment elevation myocardial infarction (NSTEMI)?

  • Vulnerable plaque
  • Myocardial infarction with no obstructive coronary artery disease
  • Atherosclerotic plaque rupture with subsequent platelet-rich thrombus overlying the culprit lesion (correct)
  • Ischemia and no obstructive coronary artery disease

    • What differentiates unstable angina (UA) and non-ST segment elevation myocardial infarction (NSTEMI)?

  • The location of the thrombus overlying the culprit lesion
  • The degree of atherosclerotic plaque rupture
  • The presence or absence of elevated cardiac biomarkers (correct)
  • The extent of coronary artery disease

    • What is the abbreviation for myocardial infarction with no obstructive coronary artery disease?

  • MINOCA (correct)
  • INOCA
  • NSTE-ACS
  • NSTEMI

    • What is the abbreviation for ischaemia and no obstructive coronary artery disease?

    <p>INOCA</p> Signup and view all the answers

    Which type of acute coronary syndrome is usually caused by an unstable atherosclerotic plaque rupture with subsequent platelet-rich thrombus overlying the culprit lesion?

    <p>Non-ST segment elevation myocardial infarction (NSTEMI)</p> Signup and view all the answers

    What forms the group of acute coronary syndromes (ACS) usually caused by atherosclerotic disease?

    <p>Unstable angina (UA) and non-ST segment elevation myocardial infarction (NSTEMI)</p> Signup and view all the answers

    Which of the following is NOT an advantage of LMWH over UFH?

    <p>Higher risk of allergic reactions</p> Signup and view all the answers

    In the setting of NSTEACS, what is the documented benefit of thrombolytic therapy?

    <p>There is no documented benefit</p> Signup and view all the answers

    Which condition is NOT considered a cause of increased myocardial metabolic demand?

    <p>Coronary occlusion</p> Signup and view all the answers

    What characterizes a transmural myocardial infarction (MI)?

    <p>Ischemic necrosis extending from the endocardium through the myocardium to the epicardium</p> Signup and view all the answers

    What is the leading cause of death in most industrialized nations throughout the world?

    <p>Myocardial infarction</p> Signup and view all the answers

    What factor determines the severity of a myocardial infarction?

    <p>The size of the affected muscle segment</p> Signup and view all the answers

    Which symptom is NOT commonly associated with a myocardial infarction?

    <p>Headache and dizziness</p> Signup and view all the answers

    When are most cases of myocardial infarction clustered?

    <p>Around midnight or early morning</p> Signup and view all the answers

    Which test is NOT required for the diagnosis of myocardial infarction?

    <p>Urinalysis</p> Signup and view all the answers

    What is the normal range for Troponin I levels in blood?

    <p>0.0- 0.4 ng/ml</p> Signup and view all the answers

    What should not delay the reperfusion strategy/treatment during diagnosis of myocardial infarction?

    <p>Blood sampling for serum markers</p> Signup and view all the answers

    What is indicated if a patient experiences syncope or near-syncope without other cause, associated with a chest pain?

    <p>Coronary angiography</p> Signup and view all the answers

    What is the best alternative for measuring injury to the heart muscle if troponin is not available?

    <p>Creatine kinase muscle and brain subunits (CK-MB)</p> Signup and view all the answers

    What is the latest generation of cardiac enzyme testing that allows for detection of very low levels of troponin?

    <p>High sensitivity troponin (hscTn)</p> Signup and view all the answers

    What is considered the best and preferred for measuring injury to the heart muscle due to its greater sensitivity and specificity?

    <p>High sensitivity troponin (hscTn)</p> Signup and view all the answers

    Which of the following is recommended for all patients without contraindications at an initial oral loading dose of 150-300 mg?

    <p>Aspirin</p> Signup and view all the answers

    Which antiplatelet agent is recommended in addition to aspirin and maintained over 12 months unless there are contraindications or an excessive risk of bleeding?

    <p>Ticagrelor</p> Signup and view all the answers

    Which antiplatelet agent is recommended in patients proceeding to interventional treatment?

    <p>Prasugrel</p> Signup and view all the answers

    When should a glycoprotein IIb/IIIa antagonist be considered?

    <p>If there are complications at angioplasty</p> Signup and view all the answers

    What should be assessed at least twice 3-6 hours apart?

    <p>Cardiac biomarkers</p> Signup and view all the answers

    What indicates ischemic dysfunction of a papillary muscle or mitral apparatus?

    <p>Increased intensity of a preexisting murmur</p> Signup and view all the answers

    What does a rise of Tn occur within after injury and peaks within 1-2 days?

    <p>2-3 hours</p> Signup and view all the answers

    What indicates overt pulmonary edema according to the Killip Classification?

    <p>Cardiogenic shock</p> Signup and view all the answers

    Which leads should be used if the standard leads are inconclusive on the electrocardiogram?

    <p>Right leads, posterior leads</p> Signup and view all the answers

    What is the primary purpose of echocardiography in the context of acute myocardial infarction?

    <p>Detecting wall motion abnormalities</p> Signup and view all the answers

    Which arrhythmia occurs most commonly during the early hours after myocardial infarction?

    <p>Sinus bradycardia</p> Signup and view all the answers

    What is the recommended treatment for premature ventricular complexes in the peri-infarct period?

    <p>β-blockers</p> Signup and view all the answers

    Which arrhythmia is associated with a higher infarct mortality when occurring in the peri-infarct period?

    <p>Atrial fibrillation</p> Signup and view all the answers

    What percentage of myocardial infarction patients experience ventricular fibrillation without antecedent-warning arrhythmias?

    <p>50%</p> Signup and view all the answers

    What is the incidence of ventricular tachycardia in cases of myocardial infarction?

    <p>20% to 40%</p> Signup and view all the answers

    Which arrhythmia occurs in approximately 10-20% of patients after myocardial infarction and is usually transient?

    <p>Atrial fibrillation</p> Signup and view all the answers

    In what percentage of myocardial infarction cases does new bundle branch block occur?

    <p>~15%</p> Signup and view all the answers

    What is the most common cause of sinus tachycardia in the peri-infarct period?

    <p>Sympathetic stimulation</p> Signup and view all the answers

    What is the impact of Wenkebach rhythm in the peri-infarct period on long-term prognosis?

    <p>It has no impact on long-term prognosis</p> Signup and view all the answers

    What is the primary reason for premature atrial contractions in patients with myocardial infarction?

    <p>Atrial or sinus node ischemia</p> Signup and view all the answers

    What is the recommended treatment for sustained ventricular tachycardia during the peri-infarct period?

    <p>Cardioversion</p> Signup and view all the answers

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