Chronic Stable Angina Symptoms and Management

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Questions and Answers

Which of the following statements regarding aldosterone antagonists in acute myocardial infarction (MI) is correct?

  • Aldosterone antagonists should be considered in patients with an ejection fraction of 40% or less, who are already receiving an ACE inhibitor (or ARB), and have heart failure symptoms or diabetes mellitus. (correct)
  • Aldosterone antagonists are not recommended in patients with hyperkalemia, defined as a potassium level greater than 4.5 mEq/L.
  • Aldosterone antagonists should be initiated within the first 2 weeks following MI in all patients, regardless of their ejection fraction or comorbidities.
  • Aldosterone antagonists are contraindicated in patients with an estimated glomerular filtration rate (eGFR) less than 30 mL/min/1.73 m^2 or serum creatinine greater than 2.5 mg/dL in men and 2.0 mg/dL in women.

Which of the following statements regarding statin therapy in acute coronary syndrome (ACS) is correct?

  • A reasonable LDL cholesterol goal for patients after an ACS event is less than 100 mg/dL.
  • Statins are contraindicated in patients with a history of liver disease or elevated liver enzymes.
  • Statins should be initiated within the first 24 hours of an ACS event, regardless of the patient's LDL cholesterol level. (correct)
  • Low-intensity statins are preferred over high-intensity statins in patients with ACS due to better tolerability.

Which of the following statements regarding the use of nitrates in acute coronary syndrome (ACS) is correct?

  • Nitrates should be initiated within the first 24 hours of an ACS event and continued indefinitely.
  • Chronic long-acting nitrate therapy has been shown to reduce cardiovascular events following myocardial infarction.
  • Nitrates are contraindicated in patients with hypotension or severe aortic stenosis.
  • Short-acting, sublingual nitroglycerin or lingual nitroglycerin spray should be prescribed to relieve anginal symptoms when necessary. (correct)

Which of the following statements regarding anticoagulation after myocardial infarction is correct?

<p>Anticoagulation with warfarin or NOACs is indicated in patients with left ventricular thrombus, a history of thromboembolic disease, or chronic atrial fibrillation. (B)</p> Signup and view all the answers

Which of the following statements regarding the management of anginal episodes in acute coronary syndrome (ACS) is correct?

<p>Patients should be instructed to take sublingual nitroglycerin and immediately call for emergency medical services if anginal symptoms persist for more than 5 minutes. (C)</p> Signup and view all the answers

Which of the following statements regarding the diagnosis of acute coronary syndrome (ACS) is correct?

<p>The presence of anginal symptoms, along with ECG changes and/or elevated cardiac biomarkers, is consistent with the diagnosis of ACS. (D)</p> Signup and view all the answers

Which of the following statements regarding the initial management of acute coronary syndrome (ACS) is correct?

<p>Antiplatelet therapy with a P2Y12 inhibitor (such as clopidogrel or ticagrelor) should be initiated as soon as possible in addition to aspirin. (B)</p> Signup and view all the answers

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