Acute coronary syndromes

The quiz
You are in the emergency department when a 54-year-old male arrives rubbing the center of his chest. He states "it feels like someone is sitting on my chest." He appears pale and his skin is diaphoretic. His radial pulse is strong, but fast. His blood pressure is 130/80 with a pulse ox of 92% on room air. He has no past medical history and takes no medications except for Tylenol for an occasional headache. He has no allergies. You take him back to a room, place in on the monitor and gain IV access.


about 3–5 minutes

Question 1 of 10

His monitor strip is as follows
Quiz question

Question 2 of 10

Although the patient is not short of breath, he should receive oxygen because

Question 3 of 10

The next priority in his assessment (within 10 minutes of arrival) is

Question 4 of 10

You complete a 12 lead ECG. The results are shown below. This ECG reveals
Quiz question

Question 5 of 10

Which medication should be given immediately upon diagnosis of myocardial infarction?

Question 6 of 10

This patient should be prepared to be transported where?

Question 7 of 10

Nitroglycerin is administered to this patient without pain relief. He continues to complain of chest pain that he rates as an 8/10. He is obviously uncomfortable. Which type of medication should be given to relieve the pain of myocardial infarction?

Question 8 of 10

The goal of pain management in acute myocardial infarction is

Question 9 of 10

You would expect this patient to be discharged on

Question 10 of 10

The size of this patient's infarction (amount of myocardium that dies) is what will determine how well he does into the future. The size of his infarction is dependent upon

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The quiz

Correct answers

  • Normal sinus rhythm.
  • His oxygen saturation is below 94%.
  • 12 Lead ECG.
  • STEMI — Anterior lateral wall infarction.
  • Aspirin
  • To the cardiac catheterization laboratory
  • Narcotics such as Morphine, Fentanyl
  • Pain free
  • Beta blocker, ace inhibitor, aspirin and a statin
  • The length of time until the vessel is opened and flow restored.

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