STEMI Treatment and Care Quiz

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What is the primary purpose of Primary PCI in the treatment of STEMI?

To initiate early rehabilitation post-MI

To provide chronic care management

To diagnose heart conditions

To restore blood flow in a timely manner (correct)

Which factor is identified as a significant barrier to improved care for STEMI patients?

Inefficient systems leading to delays (correct)

Insufficient training for medical personnel

High costs of reperfusion therapy

Excessive focus on triaging patients

Which of the following is NOT a component of the 'chain of survival' for STEMI?

Coordination of destination protocols

Expeditious implementation of reperfusion

Accurate diagnosis through imaging (correct)

Patient education about symptoms

What role does the American Heart Association play in the care of STEMI?

To maintain a national initiative for better delivery of care Signup and view all the answers

What is a requirement for a system of care for STEMI according to the established criteria?

Registration with Mission: Lifeline Signup and view all the answers

Which intervention is aimed at improving door-to-device times for STEMI patients?

Prehospital identification and activation processes Signup and view all the answers

What should a STEMI system coordinator ideally be responsible for?

Coordinating multidisciplinary team meetings Signup and view all the answers

Why is minimizing delays in reperfusion crucial for STEMI patients?

It improves overall chances of survival and heart function Signup and view all the answers

What is the primary purpose of a prehospital ECG for diagnosing STEMI?

To activate the PCI team while the patient is en route to the hospital Signup and view all the answers

What is the goal time for the PCI team to arrive at the catheterization laboratory after being paged?

20 minutes Signup and view all the answers

Which patient-related factor may correlate with a longer delay in seeking medical attention for STEMI?

Uninsured status Signup and view all the answers

What is one of the major components of time from symptom onset to reperfusion?

Time to recognize the problem and seek medical attention Signup and view all the answers

Which of the following is critical for the survival of patients with STEMI?

Immediate implementation of resuscitative efforts Signup and view all the answers

What should healthcare professionals do for patients at risk of STEMI during elective encounters?

Review and reinforce the need for urgent medical attention for specific symptoms Signup and view all the answers

Most deaths associated with STEMI occur within which timeframe after its onset?

First hour Signup and view all the answers

Which is NOT a classification of reperfusion strategies mentioned?

Emergency surgery time Signup and view all the answers

What should patients do if ischemic-type discomfort persists for more than 5 minutes?

Call emergency services Signup and view all the answers

What is one major advance in Emergency Medical Service (EMS) systems?

Ability to record a prehospital 12-lead ECG Signup and view all the answers

What is the primary goal of the STEMI care system?

Maintain total ischemic time to less than 120 minutes Signup and view all the answers

What must occur if EMS has fibrinolytic capability and the patient qualifies for therapy?

Prehospital fibrinolysis should be considered within 30 minutes of arrival Signup and view all the answers

What should be the maximum door-to-needle time for hospitals administering fibrinolytic therapy?

30 minutes or less Signup and view all the answers

What is discouraged for patients experiencing ischemic symptoms?

Self-transportation to the hospital Signup and view all the answers

What is the recommended FMC-to-device time for patients transported to a PCI-capable hospital?

90 minutes or less Signup and view all the answers

What is a key component that enhances the EMS response to STEMI patients?

Greater coordination of the EMS ambulance response Signup and view all the answers

What has been a significant change in the management of ST-elevation myocardial infarction (STEMI)?

Shift from pharmacologic to catheter-based reperfusion strategies. Signup and view all the answers

What is crucial for the management of patients with established major complications of STEMI?

Optimal management of high-risk patients. Signup and view all the answers

Which chapter addresses percutaneous coronary intervention (PCI) in patients with STEMI?

Chapter 41 Signup and view all the answers

The decline in early mortality rates among STEMI patients from 1986 to 2018 has been attributed to what?

Improvements in pharmacologic and mechanical reperfusion therapy. Signup and view all the answers

What is the primary goal of initial management for STEMI patients?

To restore blood flow to the infarct zone as rapidly as possible. Signup and view all the answers

Which medication is typically involved in the treatment of STEMI during reperfusion therapy?

Streptokinase Signup and view all the answers

What does Chapter 40 focus on in relation to coronary artery disease (CAD)?

Long-term management of patients with stable ischemic heart disease. Signup and view all the answers

What does the presence of persistent occlusion in the infarct-related artery lead to in STEMI patients?

Progressive loss of functioning myocytes. Signup and view all the answers

What percentage reduction in mortality was demonstrated through a meta-analysis of all available trials for prehospital fibrinolysis?

17% Signup and view all the answers

In the STREAM trial, what was the primary endpoint measured at 30 days?

Death, shock, heart failure, or reinfarction Signup and view all the answers

What was the percentage of patients in the fibrinolysis arm who required rescue or urgent PCI?

36% Signup and view all the answers

What was the rate of intracranial hemorrhage in the fibrinolysis group compared to the primary PCI group?

1.0% versus 0.2% Signup and view all the answers

What is generally considered a reasonable condition for the administration of prehospital fibrinolysis?

Long transportation times and physician presence in the ambulance Signup and view all the answers

In the STREAM trial, which group had a lower percentage of the primary endpoint occurring at 30 days?

Fibrinolysis arm Signup and view all the answers

What is the main comparison made in the STREAM trial?

Prehospital fibrinolysis versus primary PCI Signup and view all the answers

What time frame defines the patients included in the STREAM trial regarding symptom onset?

Within 3 hours Signup and view all the answers

What is the primary tool used for screening patients with possible acute coronary syndrome for STEMI?

12-lead ECG Signup and view all the answers

What is the recommended time frame for obtaining a 12-lead ECG in patients with suspected ischemic symptoms?

Within 10 minutes Signup and view all the answers

Which symptom suggests thrombotic occlusion of an epicardial coronary artery?

ST-segment elevation Signup and view all the answers

Which factor is NOT critical in selecting a reperfusion strategy for STEMI?

Patient's age Signup and view all the answers

What should be monitored in all patients with STEMI due to the risk of lethal arrhythmias?

Bedside ECG Signup and view all the answers

In which scenario would a patient not be considered for immediate reperfusion therapy?

ST-segment depression or T wave inversion Signup and view all the answers

What is an important evaluation for patients in non-PCI-capable hospitals regarding fibrinolytics?

Contraindications to treatment Signup and view all the answers

What is the purpose of more extensive use of prehospital 12-lead ECGs?

To assist in early triage of STEMI patients Signup and view all the answers