ACLS Acute Coronary Syndromes 5

Question 1

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?

Accepted Answer

Acute mitral regurgitation due to papillary muscle rupture

Answer

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.

Question 2

Which of the following ECG findings would indicate de Winter T-wave pattern, a STEMI-equivalent requiring emergent catheterization?

Accepted Answer

Upsloping ST depression at J-point with tall, symmetric T waves in precordial leads

Answer

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.

Question 3

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?

Accepted Answer

High-intensity statin therapy

Answer

High-intensity statin therapy (atorvastatin 40–80 mg or rosuvastatin 20–40 mg) is recommended for all ACS patients regardless of baseline LDL level.

Question 4

Which of the following correctly describes the difference between unstable angina and NSTEMI?

Accepted Answer

NSTEMI has elevated troponin; unstable angina does not

Answer

NSTEMI is distinguished from unstable angina by the presence of elevated cardiac biomarkers (troponin), indicating myocardial necrosis has occurred.

Question 5

A patient presents with STEMI and is in Killip Class IV. Which Killip class does this represent?

Accepted Answer

Cardiogenic shock

Answer

Killip Class IV is defined as cardiogenic shock with systolic BP <90 mmHg, oliguria, and peripheral vasoconstriction, carrying the highest mortality.

ACLS Practice Test

ACLS Practice Test

ACLS Acute Coronary Syndromes 5