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
A patient develops acute pulmonary edema 2 days after STEMI. Echocardiography reveals a new holosystolic murmur at the cardiac apex with radiation to the axilla. What is the most likely complication?
Answer: Acute mitral regurgitation due to papillary muscle rupture
Papillary muscle rupture causing acute mitral regurgitation typically presents 2–7 days post-STEMI with pulmonary edema and an apical holosystolic murmur radiating to the axilla.
Which of the following ECG findings would indicate de Winter T-wave pattern, a STEMI-equivalent requiring emergent catheterization?
Answer: Upsloping ST depression at J-point with tall, symmetric T waves in precordial leads
De Winter T-wave pattern is characterized by upsloping ST depression at the J-point with tall, prominent T waves in precordial leads, indicating proximal LAD occlusion.
A patient stabilized after NSTEMI is being discharged. Which long-term medication has been proven to reduce recurrent MI and cardiovascular mortality regardless of LDL level?
Answer: High-intensity statin therapy
High-intensity statin therapy (atorvastatin 40–80 mg or rosuvastatin 20–40 mg) is recommended for all ACS patients regardless of baseline LDL level.
Which of the following correctly describes the difference between unstable angina and NSTEMI?
Answer: NSTEMI has elevated troponin; unstable angina does not
NSTEMI is distinguished from unstable angina by the presence of elevated cardiac biomarkers (troponin), indicating myocardial necrosis has occurred.
A patient presents with STEMI and is in Killip Class IV. Which Killip class does this represent?
Answer: Cardiogenic shock
Killip Class IV is defined as cardiogenic shock with systolic BP <90 mmHg, oliguria, and peripheral vasoconstriction, carrying the highest mortality.
Which arrhythmia most commonly occurs within the first hour of STEMI and is the leading cause of out-of-hospital cardiac arrest in this setting?
Answer: Ventricular fibrillation
Ventricular fibrillation is the most common cause of death in the first hour of STEMI, primarily occurring before hospital arrival.
ACE inhibitors are recommended post-STEMI in which group of patients?
Answer: Patients with anterior STEMI, reduced EF < 40%, or signs of heart failure
ACE inhibitors are strongly indicated in STEMI patients with anterior wall MI, EF <40%, or clinical signs of heart failure to reduce remodeling and mortality.