Cardiac Assessment Basics
Name one high-risk symptom that may accompany chest pain.
Diaphoresis, N/V, SOB, syncope.
What does ACS stand for?
Acute Coronary Syndrome
St-Elevation usually indicates what?
Acute myocardial infarction.
What serious lung condition can cause sudden sharp chest pain and shortness of breath?
Pneumothorax.
What is the first-line medication EMS may give for suspected cardiac chest pain (unless contraindicated)?
Aspirin.
What does the “P” in OPQRST help determine during chest pain assessment?
Provocation/Palliation — what makes the pain better or worse.
What is the classic description of MI chest pain?
Crushing, pressure, tightness.
Which wave on the ECG represents ventricular depolarization?
QRS complex.
What chest pain cause worsens with breathing or movement and often improves when sitting forward?
Pericarditis.
What is the typical EMS dose of aspirin for chest pain?
324 mg (chewed).
During cardiac assessment, what does checking skin color and temperature help identify?
Signs of poor perfusion or shock.
Name one atypical MI presentation commonly seen in women or diabetics.
Fatigue, indigestion, mild discomfort, back pain, or no pain at all.
Which leads look at the anterior wall of the heart?
V1-V4.
A tearing chest pain radiating to the back suggests which condition?
Aortic dissection.
What vital sign must be checked before giving nitroglycerin?
Blood pressure.
What physical exam finding may indicate poor cardiac output in a chest pain patient?
Cool, pale, clammy skin or delayed capillary refill.
What symptom is more specific to cardiac ischemia rather than non-cardiac chest pain?
Chest pressure radiating to the jaw or left arm.
What serious arrhythmia may occur immediately after reperfusion in STEMI, and how should EMS treat it?
Ventricular tachycardia/VF — treated with defibrillation per ACLS protocol.
What life-threatening condition presents with hypotension, JVD, and muffled heart tones?
Cardiac tamponade (Beck’s triad).
Name one contraindication to nitroglycerin.
Hypotension, recent ED meds (PDE-5 inhibitors), suspected right-sided MI.
What is the minimum number of leads required to identify ST-elevation MI changes?
Two contiguous leads.
What ECG change suggests a very early MI, appearing even before ST elevation?
Hyperacute (peaked) T-waves.
ST depression in V1-V3 may indicate what reciprocal finding?
Posterior MI.
Pleuritic chest pain with recent long travel or surgery should make you suspect what?
Pulmonary embolism.
What is the maximum acceptable FMC-to-balloon time (first medical contact to PCI) that EMS systems aim for when transporting STEMI patients?
90 minutes or less