STEMI

Pathophysiology

100

This layer of the heart wall is most susceptible to ischemia and is affected first during AMI

endocardium

200

the primary vascular event that transforms a stable plaque into an acute coronary artery occlusion?

plaque rupture followed by thrombus formation/platelet aggregation

300

cellular mechanism caused by ischemia due to impairment of sodium potassium pump, leading to membrane depolarization and ST elevation on ECGs

ATP depletion and anaerobic metabolism 

400

on an ecg, this electrical phenomena causes the ST segment elevation seen in transmural ischemia resulting from the voltage differences between ischemic and non-ischemic tissue during cardiac diastole

systolic/diastolic injury

500

Following reperfusion of an occluded corononary artery, this paradoxically destructive process - mediated by reactive oxygen species, intracellular calcium overload, and opening of the mitochondrial permeability transition pore - can cause additional irreversive myocardial necrosis

reperfusion injury

Signs and Symptoms

100

Often taken lightly and blown off in the field, but can be a patient’s body signaling something is wrong

Anxiety

200

Textbook symptom for STEMI

Radiating pain

300

Secondary chief complaint due to ischemia

SOB

400

This key sign will nevaa lie

Diaphoresis

500

This s/s will cause syncope

lightheadedness

Assessment and Differentials

100

This STEMI mimic is associated with sharp chest pain that is improved by sitting up and leaning forward

pericarditis

200

When assessing a 12 lead for ST elevation, you should also look for what finding in reciprocal leads?

ST depression

300

In the mnemonic ELEVATION, O stands for which STEMI mimic?

Osborne waves (associated with hypothermia)

400

Which two mnemonics should you use during patient assessment for a STEMI?

OPQRST and SAMPLE

500

This STEMI mimic is associated with an inherited condition that can result in sudden cardiac arrest

Brugada syndrome

Treatment

100

what is the main goal of hospital treatment for STEMI?

restore blood flow to the heart

200

What are the two main medications in their dosages for emergency treatment in the field?

aspirin 324 mg

nitro 0.4 mg

300

This is the target time interval EMS/hospital systems aim for between first medical contact and PCI for STEMI patients.

What is 90 minutes.

400

This is the process aspirin slows down to block platelet aggregation

What is the prostaglandin synthesis action.

500

Nitroglycerin should be withheld if the patient has taken these class of erectile dysfunction drugs within the last 24/48 hours

What is PDE-5 inhibitors