Acute Coronary Syndrome Flashcard 6

D. Rationale: Goals of ACS therapy include identification and treatment of ACS and its symptoms.

C. Rationale: NSAIDs are associated with an increased risk of mortality, reinfarction, hypertension, heart failure, and myocardial rupture and should be discontinued during hospitalization.

D. Rationale: The FMC-to-balloon time for PCI is 90 minutes. For fibrinolytic therapy, the door-to-needle time is 30 minutes.

C. Rationale: Acute coronary syndrome is the leading cause of cardiac arrest and cardiac death if left untreated. Once diagnosed, the definitive treatment is providing early reperfusion therapies to increase survival rates.

C. Rationale: This is a case of a high-risk non-ST elevation ACS. ST segment depression is indicative of myocardial ischemia, and the presence of increased cardiac troponins makes this a high-risk case. Early reperfusion strategies are recommended, such as PCI with adjunctive therapies such as nitroglycerine, morphine, and oxygen. If PCI is not feasible after the initial coronary angiogram, other invasive strategies may be performed, such as coronary artery bypass graft.

A. Rationale: Percutaneous coronary intervention is the treatment of choice for the management of ST elevation myocardial infarction.

D. Rationale: STEMI, new-onset left bundle branch block, and non-ST elevation acute coronary syndrome can cause sudden cardiac death. These syndromes are due to coronary artery occlusion.

D. Rationale: Part of the ACLS platform is diagnosing and managing acute coronary syndrome, an umbrella term for coronary heart disease that causes acute myocardial ischemia (unstable angina), non-ST segment elevation myocardial infarction, and ST segment elevation myocardial infarction.

A. Rationale: Morphine, oxygen, nitroglycerin, and aspirin (MONA) are given as part of the immediate ED general treatment for patients with ACS. Epinephrine is used to treat a variety of dysrhythmias.

C. Rationale: Prevention of plaque formation is not a goal of treatment for ACS. Plaque will already have formed in patients with ACS. Goals for therapy include relief of ischemic chest pain, identifying and triaging patients with STEMI for early reperfusion therapy, and preventing acute, life-threatening complications such as arrhythmias.