ECC Risk Assessment & Management 2

Question 1

A 58-year-old male presents with diaphoresis, nausea, and jaw pain but denies chest pain. What is the most appropriate initial risk stratification step?

Accepted Answer

Obtain a 12-lead ECG immediately

Answer

Atypical ACS presentations (jaw pain, diaphoresis, nausea) require immediate 12-lead ECG to identify STEMI or ischemic changes.

Question 2

Which TIMI Risk Score component specifically addresses prior coronary artery disease history?

Accepted Answer

Known CAD with stenosis ≥50%

Answer

Known CAD with stenosis ≥50% is a discrete TIMI variable that increases the score by 1 point.

Question 3

A patient's HEART score totals 7. What is the recommended management pathway?

Accepted Answer

Early invasive strategy within 72 hours

Answer

A HEART score of 7–10 indicates high risk (>50% MACE) and warrants early invasive evaluation.

Question 4

Which laboratory finding is most useful for ruling OUT acute MI when measured at presentation AND 3 hours later?

Accepted Answer

High-sensitivity troponin with serial negative results

Answer

Serial high-sensitivity troponin (0h/3h protocol) has a negative predictive value >99% for ruling out NSTEMI.

Question 5

In the GRACE Risk Score, which hemodynamic variable carries the highest weight for predicting in-hospital mortality?

Accepted Answer

Killip class

Answer

Killip class carries the highest weight in GRACE scoring because it directly reflects the degree of heart failure and hemodynamic compromise.

(ECC) Emergency Cardiovascular Care Certification Practice Test

(ECC) Emergency Cardiovascular Care Certification Practice Test

ECC Risk Assessment & Management 2