Acute chest pain — Flashcards

Flashcard 1: Patients undergoing fibrinolysis for a STEMI should also be given an _____ drug

Answer: antithrombin

Flashcard 2: _____ should be given in addition to dual antiplatelet therapy in NSTEMI patients who are not at a high risk of bleeding/ having angiography immediately

Answer: Fondaparinux

Flashcard 3: A patient presents with clinical signs of ACS and raised Troponin but no ST-segment elevation on ECG (NSTEMI). The appropriate immediate pharmacological step is _____.

Answer: Aspirin 300mg

Extra: Initial management of ACS (NSTEMI/UA): 1. Aspirin 300mg (Loading dose) 2. Second antiplatelet (e.g., Ticagrelor or Clopidogrel) 3. Anticoagulation (e.g., Fondaparinux or LMWH) 4. Nitrates for pain relief 5. Beta-blockers (if not contraindicated)

Flashcard 4: In acute pericarditis, the ST segment elevation typically has a _____ shape.

Answer: concave

Extra: ST segment elevation in pericarditis is typically diffuse and concave upwards ('saddle-shaped'), unlike the convex elevation seen in MI. It is often associated with PR segment depression.

Flashcard 5: Hypothermia is a cause of _____ due to QT prolongation.

Answer: Torsades de Pointes

Flashcard 6: _____ is a risk factor for acute pericarditis

Answer: SLE

Flashcard 7: The following ECG changes may be seen in hypothermia: J waves (Osborn waves) _____ Long QT interval

Answer: first degree heart block

Flashcard 8: The ishaemic damage sustained may weaken the myocardium resulting in _____

Answer: aneurysm formation

Flashcard 9: Management of patient on warfarin with major bleeding (e.g. variceal haemorrhage, intracranial haemorrhage) involves: _____ Prothrombin complex concentrate /FFP

Answer: Give IV vitamin K 5mg

Flashcard 10: Left Ventricular Aneurysm is associated with _____ and left ventricular failure on ECG

Answer: persistent ST elevation