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Acute Coronary Syndromes Flashcards

7 cards from real ACLS practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

Read the first 7 Acute Coronary Syndromes flashcards as text

  1. A patient in the ED is diagnosed with STEMI. The nearest PCI-capable hospital is 3 hours away. What is the most appropriate reperfusion strategy?

    Answer: Administer fibrinolytic therapy if no contraindications

    When PCI cannot be performed within 120 minutes of first medical contact, fibrinolytic therapy should be administered if there are no contraindications.

  2. Which of the following is an absolute contraindication to fibrinolytic therapy in STEMI?

    Answer: Active internal bleeding or bleeding diathesis

    Active internal bleeding or bleeding diathesis is an absolute contraindication to fibrinolytic therapy due to the risk of life-threatening hemorrhage.

  3. After successful fibrinolysis for STEMI, what is the recommended time frame for transfer to a PCI-capable facility?

    Answer: 3 to 24 hours after fibrinolysis

    Guidelines recommend pharmacoinvasive strategy with transfer for angiography 3–24 hours after successful fibrinolysis.

  4. Which ECG change most reliably indicates complete reperfusion after fibrinolytic therapy?

    Answer: Greater than 50% reduction in ST elevation at 90 minutes

    A >50% reduction in ST elevation in the worst lead at 90 minutes post-fibrinolysis is a reliable marker of successful reperfusion.

  5. A patient with STEMI develops cardiogenic shock. Which intervention has the strongest evidence for improving mortality?

    Answer: Emergency primary PCI

    Emergency revascularization with primary PCI is the only intervention shown to reduce mortality in STEMI complicated by cardiogenic shock.

  6. In an ACS patient, which medication has been shown to reduce mortality when initiated within 24 hours and continued long-term?

    Answer: Beta-blockers

    Beta-blockers reduce mortality in ACS by decreasing myocardial oxygen demand, limiting infarct size, and reducing arrhythmia risk.

  7. Which of the following patients is at highest risk for a STEMI-equivalent condition requiring emergent reperfusion despite no classic ST elevation?

    Answer: Patient with Wellens syndrome pattern on ECG

    Wellens syndrome ECG pattern (biphasic or deeply inverted T waves in V2–V3) indicates critical LAD stenosis and requires urgent angiography.