Chest Pain Causes Quiz

Play an AI-generated podcast conversation about this lesson

What is the primary goal when diagnosing chest pain in the prehospital setting?

To rule out life-threatening conditions first (correct)

To identify the least critical cause

To determine the exact cause of the pain

To provide immediate treatment for cardiac ischemia

Which of the following is NOT a cardiovascular cause of chest pain?

Thoracic dissection of the aorta

Cholecystitis (correct)

Cardiac ischemia

Pericarditis

What is the term for a spectrum of coronary artery disease processes?

Myocardial infarction

Acute coronary syndrome (correct)

Cardiac ischemia

Angina pectoris

Which of the following is a musculoskeletal cause of chest pain?

Chest wall syndrome Signup and view all the answers

What is the term for inflammation of the pericardium?

Pericarditis Signup and view all the answers

Which of the following is NOT a respiratory cause of chest pain?

Cholecystitis Signup and view all the answers

What is the primary contributor to decreased oxygen supply in myocardial ischemia?

Impairment of oxygen delivery Signup and view all the answers

What is the term used to describe the clinical spectrum of myocardial ischemia, injury, and infarction?

Acute Ischemic Coronary Syndrome Signup and view all the answers

What is the main factor that leads to thrombus formation in coronary artery disease?

Atherosclerotic plaque disruption Signup and view all the answers

What is the definition of stable angina?

Transient, episodic chest discomfort resulting from myocardial ischemia Signup and view all the answers

What is the term used to describe the process of the body developing collateral circulation to compensate for decreased blood flow?

Collateral circulation Signup and view all the answers

What is the term used to describe the formation of hard, thick plaques in the coronary arteries?

Atherosclerosis Signup and view all the answers

What is the main factor that contributes to increased oxygen demand in the myocardium?

All of the above Signup and view all the answers

What is the term used to describe the diagnosis of Acute Myocardial Infarction?

ECG findings and elevated biomarkers Signup and view all the answers

What is the term used to describe the clinical entity of chest discomfort resulting from myocardial ischemia?

Angina Pectoris Signup and view all the answers

What is the term used to describe the irreversible injury of the myocardium?

Myocardial Necrosis Signup and view all the answers

What is the primary effect of atherosclerosis on the coronary arteries?

Decreases blood flow Signup and view all the answers

What proportion of patients with vasospastic angina also have atherosclerotic coronary artery disease?

Two-thirds Signup and view all the answers

What is the term for angina that occurs at rest and may not respond readily to treatment?

Unstable angina Signup and view all the answers

What is the typical duration of an angina episode?

3-5 minutes Signup and view all the answers

What is the primary difference between stable and unstable angina?

Response to treatment Signup and view all the answers

What is the significance of weak or absent peripheral pulses in an angina patient?

Potential or pending shock Signup and view all the answers

What should be done immediately in an angina patient with weak or absent peripheral pulses?

Treat for shock Signup and view all the answers

What is the significance of ST segment elevation on an ECG in a patient with Prinzmetal's angina?

Myocardial tissue ischemia Signup and view all the answers

What is the primary purpose of obtaining an ECG tracing in an angina patient?

To determine the severity of ischemia Signup and view all the answers

Why is it important to transmit the ECG tracing to the receiving medical facility?

To provide additional diagnostic detail Signup and view all the answers

What is the primary reason for rapid transport of a patient with suspected myocardial infarction?

To prevent further complications from delayed medical treatment Signup and view all the answers

Which of the following is a common precipitating event for myocardial infarction?

Formation of a thrombus in a coronary artery Signup and view all the answers

What is the term for the death of a portion of the heart muscle due to prolonged deprivation of oxygenated arterial blood?

Myocardial infarction Signup and view all the answers

Which of the following is a characteristic of a transmural infarction?

Destroys the entire thickness of the myocardium Signup and view all the answers

What is the significance of the J point in the ECG?

It marks the junction between the QRS complex and the ST segment Signup and view all the answers

What is the term for a myocardial infarction that involves the entire thickness of the myocardium and is associated with Q wave changes on the ECG?

ST-segment-elevation myocardial infarction Signup and view all the answers

Which of the following is a consequence of occlusion of the coronary artery?

Ischemia Signup and view all the answers

What is the significance of ST-segment elevation with a downward concavity in the ECG?

It is associated with acute coronary syndrome Signup and view all the answers

What can occur if the patient's underlying disease process is worsening?

Immediate transport Signup and view all the answers

What is the term for an infarction that involves only the subendocardial layer?

Subendocardial infarction Signup and view all the answers

Why is it important to administer nitroglycerin sublingually?

To dilate coronary arteries Signup and view all the answers

Which of the following is a characteristic of a non-ST-segment-elevation myocardial infarction?

It involves only the subendocardial layer Signup and view all the answers

What should be considered for chest pain that does not respond to nitrates or calcium channel blockers?

Morphine sulfate or fentanyl Signup and view all the answers

What is a common ECG finding in the patient with angina?

ST segment depression Signup and view all the answers

Why is it important to establish an IV line?

To administer medication and fluids Signup and view all the answers

What should be done if the patient refuses transport after their chest pain is relieved?

Document patient refusal and strongly encourage immediate evaluation Signup and view all the answers

What can occur if the patient has taken nitroglycerin?

Hypotension Signup and view all the answers

Why is it important to place the patient at rest in a position of physical and emotional comfort?

To decrease myocardial oxygen demand Signup and view all the answers

What can indicate that the patient's underlying disease process is worsening?

Absence of relief after receiving oxygen and/or nitrates Signup and view all the answers

Why is it important to measure any ST segment changes?

To communicate to the receiving facility Signup and view all the answers

What is the main purpose of administering radiographic contrast dye during PCI?

To visualize the coronary arteries and their anatomy Signup and view all the answers

What is the primary reason for performing coronary artery bypass grafting (CABG) over PCI?

The patient has disease that is extensive or not amenable to PCI techniques Signup and view all the answers

What is the purpose of placing a stent during PCI?

To keep the artery open after angioplasty Signup and view all the answers

What is the trend in coronary artery bypass grafting (CABG) procedures?

Performing more procedures off pump with the heart still beating Signup and view all the answers

Which of the following patients is not a candidate for CABG?

A patient with mild coronary artery disease Signup and view all the answers

What is the benefit of performing endoscopic bypass grafts?

Markedly decreasing the pain and recovery time Signup and view all the answers

What is the usual cause of occlusion in myocardial infarction?

Plaque that has broken loose Signup and view all the answers

What is the term for the ring of tissue surrounding the area of infarcted myocardium?

Ischemic tissue Signup and view all the answers

What is the most common complication of myocardial infarction?

Arrhythmias Signup and view all the answers

What is the primary strategy in managing a myocardial infarction?

Pain relief Signup and view all the answers

What is the most common chief complaint in myocardial infarction?

Chest pain Signup and view all the answers

What is the typical duration of chest pain in myocardial infarction?

More than 30 minutes Signup and view all the answers

What is the sensation often described by patients experiencing myocardial infarction?

Feeling of impending doom Signup and view all the answers

What is the result of the destruction of a portion of the myocardial muscle mass?

Heart failure Signup and view all the answers

What is the term for the heart's inability to meet the body's oxygen demands?

Inadequate tissue perfusion Signup and view all the answers

What is the importance of rapid and safe transport in managing myocardial infarction?

To facilitate reperfusion Signup and view all the answers

What is the primary concern of patients experiencing chest pain for the first time?

Fear of death Signup and view all the answers

What is a characteristic of a patient who has suffered an MI before?

They are less concerned about the current pain Signup and view all the answers

What is the significance of a patient's blood pressure during an MI?

It can be elevated, normal, or lower than normal Signup and view all the answers

What is the purpose of examining the ST segment in a 12-lead ECG?

To examine the ST segment for height, depth, and overall contour Signup and view all the answers

What is the significance of a pathological Q wave?

It indicates infarcted tissue or extensive transient ischemia Signup and view all the answers

What is the most serious threat to patients before they arrive at the emergency department?

Cardiac arrhythmias Signup and view all the answers

What is the purpose of reperfusion therapy?

To stop further injury and reperfuse ischemic tissue Signup and view all the answers

What is the window of time in which a fibrinolytic can be given and be effective?

6 hours from the onset of symptoms Signup and view all the answers

What is the purpose of percutaneous coronary intervention (PCI)?

To take the patient to the lab for diagnosis and treatment Signup and view all the answers

What is a complication of giving fibrinolytics?

Hemorrhage, allergic reactions, and reperfusion arrhythmias Signup and view all the answers

What is the primary purpose of ascertaining the exact time of symptom onset in a patient with suspected myocardial infarction?

To determine the patient's eligibility for fibrinolytic therapy Signup and view all the answers

What should the EMS provider assume if they are unsure whether a patient meets local criteria for fibrinolytic therapy?

That the patient meets the criteria Signup and view all the answers

Why is it essential to weigh treating the patient's pain against rapid transport?

To balance the need for pain relief with the urgency of reperfusion Signup and view all the answers

What is the primary goal of using a checklist similar to those used in emergency departments?

To reduce the wait time for patients who meet the clinical criteria for fibrinolytic therapy Signup and view all the answers

What information should the emergency physician or staff relay to the EMS provider?

The time of the pain's onset, ST segment elevation, and location of ischemia and infarction on the 12-lead ECG Signup and view all the answers

Why is it important to consider the patient's anxiety and apprehension when managing myocardial infarction?

To reduce the patient's anxiety and apprehension during transport Signup and view all the answers

What is the primary effect of increased peripheral vascular resistance on stroke volume?

It decreases stroke volume Signup and view all the answers

What is the primary consequence of the myocardial muscle being stretched too far?

It cannot contract properly Signup and view all the answers

In congestive heart failure, what is the typical presentation of edema?

Pulmonary, peripheral, and ascites Signup and view all the answers

What is the estimated number of new cases of congestive heart failure diagnosed each year in the United States?

550,000 Signup and view all the answers

What is the primary mortality outcome in 50% of congestive heart failure patients within 5 years?

Pulmonary edema and respiratory failure Signup and view all the answers

What is the primary assessment priority when evaluating a patient with suspected congestive heart failure?

Evaluating the patient's skin color and breathing Signup and view all the answers

What is the primary symptom reported by patients with pulmonary edema?

Shortness of breath and coughing Signup and view all the answers

What is the primary concern when managing a patient with congestive heart failure and respiratory failure?

Oxygenation and ventilation Signup and view all the answers

What is the primary medication class used to decrease afterload in congestive heart failure patients?

ACE inhibitors Signup and view all the answers

What is the primary reason for assessing a patient's chief complaint and medical history in congestive heart failure?

To evaluate the patient's symptoms and disease progression Signup and view all the answers

What is the primary reason for administering oxygen to a patient suspected of MI?

To correct hypoxia and decrease myocardial oxygen demand Signup and view all the answers

What should be considered when establishing IV access in a patient suspected of MI?

Avoiding multiple attempts to minimize the risk of fibrinolytic therapy Signup and view all the answers

What medication is typically indicated for patients suspected of MI to relieve chest pain?

Nitroglycerin Signup and view all the answers

What is the significance of monitoring the ECG constantly in a patient suspected of MI?

To detect life-threatening arrhythmias Signup and view all the answers

What should be done if a patient suspected of MI refuses transport after chest pain relief?

Convince the patient to be transported to the hospital Signup and view all the answers

What indicates myocardial damage in a patient suspected of MI?

Increase in creatine kinase (CK) levels Signup and view all the answers

What is the purpose of rapid transport in a patient suspected of MI?

To reduce the door-to-balloon time Signup and view all the answers

What is the significance of the ST segment in a 12-lead ECG?

It diagnoses myocardial ischemia or infarction Signup and view all the answers

What should be done when a patient suspected of MI has hypotension?

Transport the patient rapidly to the hospital Signup and view all the answers

What is the primary concern when a patient suspected of MI refuses transport?

The patient's risk of myocardial damage or death Signup and view all the answers

What is the primary consideration when applying CPAP to a patient?

Using the lowest effective pressure Signup and view all the answers

What is a contraindication for CPAP?

Suspected pneumothorax Signup and view all the answers

What should be done every 5 minutes when administering CPAP?

Check and document vital signs Signup and view all the answers

What is an important consideration when using CPAP in patients with a DNR order?

CPAP can be used on patients with a DNR order Signup and view all the answers

Why is it important to monitor the patient for gastric distension when using CPAP?

It can cause vomiting Signup and view all the answers

What is the primary purpose of administering medications when using CPAP?

To treat underlying conditions Signup and view all the answers

What is the primary reason for measuring CK-MB levels in patients with suspected myocardial infarction?

To determine the extent of cardiac damage Signup and view all the answers

What is the advantage of using high-sensitivity troponin (hs-cTnC) assays in diagnosing myocardial infarction?

They can detect much lower concentrations of the troponin protein Signup and view all the answers

What is the significance of a reversal of the ratio of LDH isoenzymes in diagnosing myocardial infarction?

It is a specific indicator of cardiac injury Signup and view all the answers

What is the primary advantage of using myoglobin levels in diagnosing myocardial infarction?

It is a rapid indicator of cardiac damage Signup and view all the answers

What is the primary purpose of obtaining cardiac enzyme levels in patients with chest pain?

To diagnose myocardial infarction Signup and view all the answers

What is the significance of elevated CK-MB levels in patients with suspected myocardial infarction?

It indicates cardiac damage Signup and view all the answers

What is the primary advantage of using troponin I levels in diagnosing myocardial infarction?

It is a specific indicator of cardiac injury Signup and view all the answers

What is the primary reason for using cardiac enzymes in conjunction with ECG findings and other diagnostic testing in diagnosing myocardial infarction?

To increase the specificity of the diagnosis Signup and view all the answers

What is the significance of a peak level of CK-MB at 24 hours after myocardial infarction?

It indicates the time of onset of myocardial infarction Signup and view all the answers

What is the primary purpose of using LDH levels in diagnosing myocardial infarction?

To diagnose cardiac damage Signup and view all the answers

What is the primary consequence of left ventricular failure?

Back pressure of blood into the pulmonary circulation Signup and view all the answers

Which of the following is a common cause of right ventricular failure?

Left ventricular failure Signup and view all the answers

What is the term that describes the ability of heart failure patients to compensate, at least for a time?

Starling's law of the heart Signup and view all the answers

What is the result of pulmonary capillary pressure becoming too high in left ventricular failure?

Forced blood plasma into the alveoli Signup and view all the answers

What is the primary effect of coronary artery disease on the heart?

Impaired heart's mechanical performance Signup and view all the answers

What is the primary cause of systolic left ventricular failure?

Inability of the left ventricle to contract completely Signup and view all the answers

What is the consequence of right ventricular failure?

Back pressure of blood into the systemic venous circulation Signup and view all the answers

What is the primary cause of diastolic left ventricular failure?

Inability of the left ventricle to relax completely Signup and view all the answers

What is the term used to describe heart failure due to pulmonary disease?

Cor pulmonale Signup and view all the answers

What is the primary cause of pulmonary edema in left ventricular failure?

Increased pulmonary capillary pressure Signup and view all the answers

What is the most common symptom of CHF, which worsens with activity?

Labored breathing Signup and view all the answers

What is the significance of a patient using multiple pillows to sleep?

More severe PND Signup and view all the answers

What is the likely finding in a patient with severe pulmonary edema?

Rhonchi and wheezes Signup and view all the answers

What is the purpose of seating a patient with feet dangling in CHF?

To decrease preload Signup and view all the answers

What is the effect of nitroglycerin on CHF patients?

Decreases peripheral edema Signup and view all the answers

What is the significance of pulsus paradoxus in CHF?

Compression of great vessels or ventricles Signup and view all the answers

What is the purpose of administering oxygen in CHF patients with pulmonary edema?

To correct hypoxia Signup and view all the answers

What is the complication of pulmonary edema that can quickly lead to death?

Respiratory failure Signup and view all the answers

What is the characteristic of a patient with severe pulmonary edema?

Tachypnea Signup and view all the answers

What is the significance of wheezes in CHF patients?

Sign of cardiac asthma Signup and view all the answers

What is the primary goal of CPAP therapy in patients with acute CHF?

To force excess fluid out of the alveoli and back into the pulmonary capillaries Signup and view all the answers

Why is morphine no longer a recommended medication for acute CHF?

It worsens CHF outcomes Signup and view all the answers

What is the primary effect of CPAP/BiPAP on the left ventricle in patients with acute CHF?

It decreases the left ventricle's workload Signup and view all the answers

What is the difference between CPAP and PEEP?

CPAP is applied during the entire respiratory cycle, while PEEP is applied only during expiration Signup and view all the answers

Why is it important to limit fluids in patients with acute CHF?

To prevent excessive fluid buildup in the lungs Signup and view all the answers

What is the primary benefit of using ACE inhibitors in the treatment of acute CHF?

They reduce afterload Signup and view all the answers

What is the primary effect of CPAP/BiPAP on pulmonary gas exchange in patients with acute CHF?

It improves pulmonary gas exchange by forcing excess fluid out of the alveoli Signup and view all the answers

What is the primary concern when using CPAP/BiPAP at high pressures?

The risk of barotrauma increases Signup and view all the answers

What is the primary benefit of using albuterol in the treatment of acute CHF?

It is an adrenergic bronchodilator Signup and view all the answers

Why is it important to establish IV access in patients with acute CHF?

To administer medications Signup and view all the answers

What is the primary purpose of a Left Ventricular Assist Device (LVAD)?

To aid patients whose physical condition precludes them from a heart transplant Signup and view all the answers

What is the normal mean arterial pressure (MAP) for a patient with a Left Ventricular Assist Device (LVAD)?

60–80 mmHg Signup and view all the answers

What is unique about the flow technology used in Left Ventricular Assist Devices (LVADs)?

The flow is continuous Signup and view all the answers

How many power connections are required to power the controller and pump of a Left Ventricular Assist Device (LVAD)?

Two Signup and view all the answers

What is the purpose of the tube that passes through the skin in a Left Ventricular Assist Device (LVAD) system?

To connect the pump to the external controller and power source Signup and view all the answers

What can be challenging to obtain in patients with a Left Ventricular Assist Device (LVAD)?

Pulse oximetry readings Signup and view all the answers

What is the typical presentation of a patient with cardiac tamponade?

Dyspnea and orthopnea Signup and view all the answers

What should be done when transporting a patient with an LVAD?

Bring two batteries and the backup controller Signup and view all the answers

What is the primary goal of management in cardiac tamponade?

Supportive treatment and maintaining perfusion Signup and view all the answers

What is the significance of jugular vein distension in cardiac tamponade?

It indicates an increase in venous pressure Signup and view all the answers

What is the characteristic of the ECG in cardiac tamponade?

It shows a decrease in QRS and T wave voltages Signup and view all the answers

What is the significance of pulsus paradoxus in cardiac tamponade?

It indicates a decrease in systolic pressure Signup and view all the answers

What is the underlying cause of cardiac tamponade?

Pericardial effusion of air, pus, serum, blood, or any combination of these Signup and view all the answers

What is the significance of a muffled heart sound in cardiac tamponade?

It indicates a pericardial effusion Signup and view all the answers

What is the primary concern when managing a patient with an LVAD?

Monitoring for signs of cardiac tamponade Signup and view all the answers

What should be done when the VAD alarm is sounding?

Check the connections and make sure batteries are charged Signup and view all the answers

What is the primary purpose of performing pericardiocentesis in a patient with cardiac tamponade?

To aspirate fluid from the pericardium Signup and view all the answers

What is the most common cause of hypertensive emergency?

Medication noncompliance Signup and view all the answers

What is the blood pressure threshold for diagnosing preeclampsia?

140/90 mmHg Signup and view all the answers

What is the primary consequence of untreated preeclampsia?

Eclampsia and death Signup and view all the answers

What is the approximate prevalence of hypertension in the United States?

100 million Signup and view all the answers

What is the primary reason for rapid transport in a patient with cardiac tamponade?

To perform pericardiocentesis Signup and view all the answers

What is the primary difference between a hypertensive emergency and a hypertensive urgency?

Presence of end-organ damage Signup and view all the answers

What is the primary complication of hypertensive encephalopathy?

Stroke Signup and view all the answers

What is the primary cause of death in patients with preeclampsia?

Eclampsia Signup and view all the answers

What is the primary concern when a patient with cardiac tamponade refuses transport?

Delayed treatment Signup and view all the answers

What is the primary mechanism by which the body tries to compensate in cardiogenic shock?

Increasing contractile force, or improving preload, or reducing peripheral resistance Signup and view all the answers

What is the most common presentation of cardiogenic shock in geriatric patients?

As an end-stage event with significant underlying disease(s) Signup and view all the answers

What is the usual heart rhythm in cardiogenic shock?

Sinus tachycardia Signup and view all the answers

What is the primary cause of high mortality rate in geriatric patients with cardiogenic shock?

Multiple end-organ damage reaches the point that life cannot be sustained Signup and view all the answers

What is the significance of radial pulses in cardiogenic shock?

They are initially present but later disappear Signup and view all the answers

What is the primary reason for assessing the patient's past medical history in cardiogenic shock?

To identify any recent trauma or hypovolemic cause Signup and view all the answers

What is the primary respiratory finding in cardiogenic shock?

All of the above Signup and view all the answers

What is the primary indication of cardiogenic shock in the early stages?

Cold extremities, weak pulses, and low blood pressure Signup and view all the answers

What is the primary significance of the patient's medication history in cardiogenic shock?

It indicates the patient's underlying disease processes Signup and view all the answers

What is the primary consequence of preload, afterload, and contractility failing to meet vital organ demands in cardiogenic shock?

Unconsciousness and eventually death Signup and view all the answers

What is the primary problem during the electrical phase of cardiac arrest?

Disordered electrical conduction Signup and view all the answers

At what time interval after cardiac arrest does the circulatory phase begin?

4 minutes Signup and view all the answers

What is the result of anaerobic metabolism in the myocardial cells during the circulatory phase?

Marked decrease in energy production Signup and view all the answers

Why is immediate defibrillation during the circulatory phase detrimental?

The heart is not prepared for a shock Signup and view all the answers

What is the primary benefit of administering epinephrine during the circulatory phase?

Prepares the myocardium for a shock Signup and view all the answers

What is the characteristic of the metabolic phase of cardiac arrest?

Severe hypoxia and severe acidosis Signup and view all the answers

What is the result of the failure of the sodium-potassium pump in the metabolic phase?

Cellular swelling Signup and view all the answers

What is the consequence of the loss of the barrier between the GI tract and the rest of the body in the metabolic phase?

Bacteria can enter the body Signup and view all the answers

What is the benefit of providing at least 90 seconds of CPR before defibrillation during the circulatory phase?

Increases survival rates Signup and view all the answers

What is the primary difference between the electrical and circulatory phases of cardiac arrest?

The heart is prepared for a shock in the electrical phase but not in the circulatory phase Signup and view all the answers

What is the primary characteristic of a hypertensive emergency?

Target-organ changes such as confusion, seizures, or ECG changes Signup and view all the answers

What is the indication for treating a hypertensive patient with supportive care and reassurance only?

Hypertensive urgency with symptoms such as chest pain, headache, or shortness of breath Signup and view all the answers

What is the typical presentation of a hypertensive patient?

Chief complaint of headache accompanied by nausea and/or vomiting, blurred vision, shortness of breath, chest pain, epistaxis, and vertigo Signup and view all the answers

What is the possible cause of hypertension in a patient who has been noncompliant with their medication regimen?

All of the above Signup and view all the answers

What is the definition of hypertension?

Systolic pressure greater than 160 mmHg and diastolic pressure greater than 90 mmHg Signup and view all the answers

What is the significance of a strong and bounding pulse in a hypertensive patient?

Is a common presentation of hypertension Signup and view all the answers

What is the primary concern when evaluating a patient with hypertension?

Evaluating the patient's airway, breathing, and circulation Signup and view all the answers

What is the term for shock that occurs when left ventricular function is compromised and the heart cannot meet the body's metabolic demands?

Cardiogenic shock Signup and view all the answers

What is the purpose of placing a saline lock in a hypertensive patient?

To establish an IV for medication administration Signup and view all the answers

What is the recommendation for transporting a pregnant patient with hypertension?

Transport on the left side to reduce pressure on the vena cava Signup and view all the answers

What is the primary reason for the patient's need for emergent revascularization and reperfusion?

To treat the underlying cardiac problem Signup and view all the answers

What is the most critical factor in prehospital care for cardiogenic shock patients?

Rapidly transporting the patient to a facility with interventional cardiology capabilities Signup and view all the answers

What is the mechanism of death in sudden death from coronary artery disease?

Lethal arrhythmia Signup and view all the answers

During the electrical phase of cardiac arrest, what is available to the myocardial cells?

Adequate oxygen Signup and view all the answers

What is the purpose of understanding the pathophysiology of cardiac arrest and sudden death?

To understand current treatment regimens for cardiac arrest Signup and view all the answers

What is the primary difference between the electrical phase and the circulatory phase of cardiac arrest?

The duration of cardiac arrest Signup and view all the answers

What is the significance of the three phases of cardiac arrest?

They guide the type of prehospital intervention required Signup and view all the answers

What is the primary cause of cardiac arrest and sudden death?

Atherosclerotic disease Signup and view all the answers

What is the result of cardiac arrest?

Systemic circulatory failure Signup and view all the answers

What is the significance of the patient's position in managing cardiogenic shock?

It influences the patient's comfort and hemodynamic stability Signup and view all the answers

What is the primary effect of endotoxins and cytokines released by Gram-negative bacteria on the heart?

Suppressed myocardial function Signup and view all the answers

What is the primary goal of resuscitative measures during the metabolic phase?

To control injurious factors during reperfusion Signup and view all the answers

What is the characteristic ECG abnormality associated with Brugada syndrome?

Right bundle branch block with ST segment elevation Signup and view all the answers

What is the primary benefit of administering antiendotoxin antibodies in septic shock?

To minimize the detrimental effects of endotoxins Signup and view all the answers

What is the typical age range for arrhythmias to occur in patients with Brugada syndrome?

30-40 years Signup and view all the answers

What is the primary cause of cardiac arrest in patients with Long QT syndrome?

Polymorphic ventricular tachycardia Signup and view all the answers

What is the primary effect of hypothermia on cardiac function?

Reduced metabolic demand Signup and view all the answers

What is the primary benefit of administering anti-inflammatory agents in septic shock?

To reduce inflammation Signup and view all the answers

What is the primary benefit of using metabolically focused therapies in the metabolic phase?

To correct electrolyte problems Signup and view all the answers

What is the primary inheritance pattern of Brugada syndrome?

Autosomal dominant with incomplete penetrance Signup and view all the answers

What is the typical demographic affected by commotio cordis?

Young, otherwise healthy male athletes Signup and view all the answers

What is the correct sequence of actions when responding to a cardiac arrest patient?

Initiate CPR, place ECG leads, and then confirm asystole in two or more leads Signup and view all the answers

What is the primary goal when evaluating the downtime of a cardiac arrest patient?

To determine the total downtime from the beginning of the arrest to delivery to the emergency department Signup and view all the answers

What is the significance of ventricular fibrillation in commotio cordis?

It is triggered by chest wall impact only over the heart Signup and view all the answers

What is the primary purpose of asking certain questions when evaluating a cardiac arrest patient?

To focus on events prior to the arrest Signup and view all the answers

What is the effective treatment for commotio cordis?

CPR and early defibrillation Signup and view all the answers

What is the primary goal of resuscitation in a patient experiencing cardiac arrest?

To obtain return of spontaneous circulation Signup and view all the answers

What is the revised mnemonic for the preferred sequence of primary assessment and management of an emergency patient in cardiac arrest?

CAB (circulation, airway, breathing) Signup and view all the answers

When should a shock be delivered during CPR?

After checking the rhythm Signup and view all the answers

What is the significance of field termination of resuscitation (TOR) in patients unlikely to survive?

It reserves EMS resources for patients who truly have the possibility of benefiting from EMS care Signup and view all the answers

What is the significance of postarrest care in cardiac arrest management?

It is almost as important as prearrest care Signup and view all the answers

What is the primary reason for administering high-concentration oxygen during CPR?

To supply oxygen to the patient Signup and view all the answers

When should epinephrine be administered during CPR?

During the next CPR interval Signup and view all the answers

What is the primary difference between return of spontaneous circulation (ROSC) and survival?

ROSC refers to the patient's spontaneous pulse and breathing, while survival refers to the patient's survival to be discharged from the hospital Signup and view all the answers

What is the primary consideration for field termination of resuscitation (TOR) in patients unlikely to survive?

The absence of ROSC, a shockable rhythm, and reversible causes Signup and view all the answers

What is the primary benefit of continued resuscitation measures in patients who achieve ROSC?

It increases the patient's chance of survival Signup and view all the answers

What is the ideal range of systolic blood pressure in the postarrest patient?

80 to 100 mmHg Signup and view all the answers

What is the primary benefit of induced therapeutic hypothermia in cardiac arrest survivors?

Minimizes the effects of hypoxic injury and oxidative stress Signup and view all the answers

At what temperature is the patient typically cooled during induced therapeutic hypothermia?

32° to 36° C Signup and view all the answers

What is the purpose of extracorporeal membrane oxygenation (ECMO) in postcardiac arrest patients?

To support life and take strain off the heart and lungs until the patient's own organs have recovered Signup and view all the answers

What is the term used to describe the use of ECMO in arrested patients?

Extracorporeal cardiopulmonary resuscitation (ECPR) Signup and view all the answers

What is the primary underlying factor in many cardiovascular emergencies?

Atherosclerosis Signup and view all the answers

What is the decision not to attempt resuscitation based on?

Certainty that the patient will not survive Signup and view all the answers

What is the purpose of using chilled IV fluids and ice packs in induced therapeutic hypothermia?

To cool the patient to a temperature of 32° to 36° C Signup and view all the answers

What is the primary benefit of transporting patients with an ROSC to a designated facility?

To initiate induced therapeutic hypothermia as part of the bundle of postresuscitation care strategies Signup and view all the answers

What is the term used to describe the formation of hard, thick plaques in the coronary arteries?

Atherosclerosis Signup and view all the answers

What is the significance of bruits audible over the affected carotid artery in a patient with a vascular emergency?

It is a sign of peripheral arterial atherosclerotic disease. Signup and view all the answers

What is the primary goal of management in a patient with a vascular emergency?

To provide supportive care and arrange for rapid transport. Signup and view all the answers

Why should the patient be placed in a position of comfort during a vascular emergency?

To reduce anxiety and discomfort. Signup and view all the answers

What is an indication for rapid transport with lights and sirens in a patient with a vascular emergency?

The patient's symptoms are not relieved by medication. Signup and view all the answers

What should be done before administering any medication to a patient with a vascular emergency?

Ask the patient or family members about medication allergies. Signup and view all the answers

What is the consequence of a patient refusing transport in a vascular emergency?

The patient is likely to experience serious complications without further medical attention. Signup and view all the answers

What is the primary mechanism by which atherosclerosis damages the tunica media?

Injury response to fat deposition under the tunica intima Signup and view all the answers

What is the most common location of an abdominal aortic aneurysm?

Below the renal arteries and above the bifurcation of the common iliac arteries Signup and view all the answers

What is the primary cause of infectious aneurysms?

Syphilis Signup and view all the answers

What is the term for the dilation of a vessel?

Aneurysm Signup and view all the answers

What is the primary consequence of untreated dissecting aortic aneurysm?

Rupture of the aortic wall Signup and view all the answers

What is the estimated incidence of abdominal aortic aneurysm in men versus women?

10 times more common in men Signup and view all the answers

What is the primary cause of degenerative changes in the smooth muscle and elastic tissue of the aortic media?

Cystic medial necrosis Signup and view all the answers

What is the primary location of dissecting aortic aneurysms?

Ascending aorta Signup and view all the answers

What is the primary consequence of atherosclerosis on the vessel's intimal surface?

Destruction of the vessel's elasticity Signup and view all the answers

What is the primary condition that can cause disability and death due to a blood clot forming in a vein and then dislodging and traveling in the blood?

Venous thromboembolism Signup and view all the answers

What is the most common cause of acute arterial occlusion?

Emboli Signup and view all the answers

What is the term used to describe the formation of a blood clot in a deep vein?

Deep vein thrombosis Signup and view all the answers

What is the consequence of a pulmonary embolism blocking the blood flow through a vessel?

The right heart must pump against increased resistance Signup and view all the answers

What is the term used to describe the inflammation of blood vessels?

Vasculitis Signup and view all the answers

What is the best strategy for VTE?

Prevention Signup and view all the answers

What is the common symptom of a patient with DVT?

Gradually increasing pain or tenderness in the calf Signup and view all the answers

What is the term used to describe the discomfort behind the knee associated with DVT?

Homan’s sign Signup and view all the answers

What can occur if the patient has a genetic predisposition for clot formation?

Increased risk of clot formation Signup and view all the answers

What is the term used to describe the progressive degenerative disease of the midsize and large arteries?

Peripheral arterial atherosclerotic disease Signup and view all the answers

What is the consequence of a blocked vessel in the lung?

The area of the lung supplied by the occluded vessel stops functioning Signup and view all the answers

What is the characteristic of pain in patients with peripheral arterial disease?

It is present even at rest Signup and view all the answers

What is the significance of absent pulses in a patient with vascular emergency?

It is a sign of occlusion distal to the affected area Signup and view all the answers

What is the consequence of untreated occlusion of any vessel?

It can cause severe disability or death Signup and view all the answers

What is the purpose of checking the five Ps in a patient with vascular emergency?

To check for signs of ischemia Signup and view all the answers

What is the typical presentation of a patient with peripheral arterial disease?

Cold, numb, and painful extremity Signup and view all the answers

What is the significance of a sudden onset of pain in a patient with vascular emergency?

It is a sign of acute occlusion Signup and view all the answers

What is the purpose of assessing the patient's chief complaint and medical history in vascular emergency?

To determine the contributing history of the patient Signup and view all the answers

What is the consequence of pulmonary occlusion?

It can cause severe disability or death Signup and view all the answers

What is the significance of unequal bilateral blood pressures in a patient with vascular emergency?

It is a sign of high thoracic aneurysm Signup and view all the answers

What is the purpose of the OPQRST acronym in a patient with vascular emergency?

To elicit the patient's description of symptoms and pain Signup and view all the answers

Chest Pain Causes Quiz

Podcast Beta

Questions and Answers

What is the primary goal when diagnosing chest pain in the prehospital setting?

Which of the following is NOT a cardiovascular cause of chest pain?

What is the term for a spectrum of coronary artery disease processes?

Which of the following is a musculoskeletal cause of chest pain?

What is the term for inflammation of the pericardium?

Which of the following is NOT a respiratory cause of chest pain?

What is the primary contributor to decreased oxygen supply in myocardial ischemia?

What is the term used to describe the clinical spectrum of myocardial ischemia, injury, and infarction?

What is the main factor that leads to thrombus formation in coronary artery disease?

What is the definition of stable angina?

What is the term used to describe the process of the body developing collateral circulation to compensate for decreased blood flow?

What is the term used to describe the formation of hard, thick plaques in the coronary arteries?

What is the main factor that contributes to increased oxygen demand in the myocardium?

What is the term used to describe the diagnosis of Acute Myocardial Infarction?

What is the term used to describe the clinical entity of chest discomfort resulting from myocardial ischemia?

What is the term used to describe the irreversible injury of the myocardium?

What is the primary effect of atherosclerosis on the coronary arteries?

What proportion of patients with vasospastic angina also have atherosclerotic coronary artery disease?

What is the term for angina that occurs at rest and may not respond readily to treatment?

What is the typical duration of an angina episode?

What is the primary difference between stable and unstable angina?

What is the significance of weak or absent peripheral pulses in an angina patient?

What should be done immediately in an angina patient with weak or absent peripheral pulses?

What is the significance of ST segment elevation on an ECG in a patient with Prinzmetal's angina?

What is the primary purpose of obtaining an ECG tracing in an angina patient?

Why is it important to transmit the ECG tracing to the receiving medical facility?

What is the primary reason for rapid transport of a patient with suspected myocardial infarction?

Which of the following is a common precipitating event for myocardial infarction?

What is the term for the death of a portion of the heart muscle due to prolonged deprivation of oxygenated arterial blood?

Which of the following is a characteristic of a transmural infarction?

What is the significance of the J point in the ECG?

What is the term for a myocardial infarction that involves the entire thickness of the myocardium and is associated with Q wave changes on the ECG?

Which of the following is a consequence of occlusion of the coronary artery?

What is the significance of ST-segment elevation with a downward concavity in the ECG?

What can occur if the patient's underlying disease process is worsening?

What is the term for an infarction that involves only the subendocardial layer?

Why is it important to administer nitroglycerin sublingually?

Which of the following is a characteristic of a non-ST-segment-elevation myocardial infarction?

What should be considered for chest pain that does not respond to nitrates or calcium channel blockers?

What is a common ECG finding in the patient with angina?

Why is it important to establish an IV line?

What should be done if the patient refuses transport after their chest pain is relieved?

What can occur if the patient has taken nitroglycerin?

Why is it important to place the patient at rest in a position of physical and emotional comfort?

What can indicate that the patient's underlying disease process is worsening?

Why is it important to measure any ST segment changes?

What is the main purpose of administering radiographic contrast dye during PCI?

What is the primary reason for performing coronary artery bypass grafting (CABG) over PCI?

What is the purpose of placing a stent during PCI?

What is the trend in coronary artery bypass grafting (CABG) procedures?

Which of the following patients is not a candidate for CABG?

What is the benefit of performing endoscopic bypass grafts?

What is the usual cause of occlusion in myocardial infarction?

What is the term for the ring of tissue surrounding the area of infarcted myocardium?

What is the most common complication of myocardial infarction?

What is the primary strategy in managing a myocardial infarction?

What is the most common chief complaint in myocardial infarction?

What is the typical duration of chest pain in myocardial infarction?

What is the sensation often described by patients experiencing myocardial infarction?

What is the result of the destruction of a portion of the myocardial muscle mass?

What is the term for the heart's inability to meet the body's oxygen demands?

What is the importance of rapid and safe transport in managing myocardial infarction?

What is the primary concern of patients experiencing chest pain for the first time?

What is a characteristic of a patient who has suffered an MI before?

What is the significance of a patient's blood pressure during an MI?

What is the purpose of examining the ST segment in a 12-lead ECG?

What is the significance of a pathological Q wave?

What is the most serious threat to patients before they arrive at the emergency department?

What is the purpose of reperfusion therapy?

What is the window of time in which a fibrinolytic can be given and be effective?

What is the purpose of percutaneous coronary intervention (PCI)?

What is a complication of giving fibrinolytics?

What is the primary purpose of ascertaining the exact time of symptom onset in a patient with suspected myocardial infarction?

What should the EMS provider assume if they are unsure whether a patient meets local criteria for fibrinolytic therapy?

Why is it essential to weigh treating the patient's pain against rapid transport?

What is the primary goal of using a checklist similar to those used in emergency departments?

What information should the emergency physician or staff relay to the EMS provider?