Medications
What is an example medication used to prevent blood clots in post-MI patients?
aspirin (or anticoagulants)
Source: American Heart Association. (2021). Secondary prevention and risk reduction therapy for patients with coronary and other atherosclerotic vascular disease.
What is the recommended minimum weekly exercise duration for a post-MI patient?
150 mins
Source: American College of Cardiology, 2019
What is the recommended blood pressure target for post-MI patients?
Below 140/90 mmHg
Source: Whelton, P. K., Carey, R. M., Aronow, W. S., et al. (2018). 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults. Journal of the American College of Cardiology, 71(19), e127–e248. https://doi.org/10.1016/j.jacc.2017.11.006
Why is medication adherence critical in post-MI patients?
Prevents recurrence and improves survival
Source: American Heart Association, 2021
Mr. L is taking Pravastatin 20 mg daily. What should his LDL goal be?
Less than 100 mg/dL
Source: Grundy, S. M., Stone, N. J., Bailey, A. L., et al. (2018). 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA guideline on the management of blood cholesterol. Journal of the American College of Cardiology, 73(24), e285–e350. https://doi.org/10.1016/j.jacc.2018.11.003
What is the target LDL cholesterol level for a patient post-MI on statin therapy?
Less than 100 mg/dL
Source: Grundy, S. M., Stone, N. J., Bailey, A. L., et al. (2018). 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA guideline on the management of blood cholesterol. Journal of the American College of Cardiology, 73(24), e285–e350. https://doi.org/10.1016/j.jacc.2018.11.003
Name a dietary change recommended for patients post-MI.
Consume vegetables, fruits, nuts, whole grains, lean vegetable or animal protein, and fish and minimizes the intake of trans fats, red meat and processed red meats, refined carbohydrates, and sugar-sweetened beverages
Source: American College of Cardiology, 2019
How often should lipid levels be checked post-MI to ensure goals are met?
4 to 12 weeks after treatment initiation and follow-up testing every 3 to 12 months
Source: Akpalu, Y. A., Anderson, M. B., Owusu-Agyei, S., & Boakye, M. A. (2022). Lipid Testing Trends Before and After Hospitalization for Myocardial Infarction Among Adults in the United States. https://doi.org/10.2147/CLEP.S361258
How can family members support post-MI recovery at home?
Encouraging lifestyle changes, attending appointments, and learning emergency response steps
Mr. L has fatigue and SOB with activity. What condition might this suggest, given his history?
Possible heart failure
What medication can be used if a beta-blocker is contraindicated for post-MI patients?
ACE inhibitors or ARBs
Source: Yancy, C. W., Jessup, M., Bozkurt, B., et al. (2017). 2017 ACC/AHA/HFSA focused update of the 2013 ACCF/AHA guideline for the management of heart failure. Journal of the American College of Cardiology, 70(6), 776–803. https://doi.org/10.1016/j.jacc.2017.04.025
Why is smoking cessation emphasized in post-MI patient education?
Smoking increases the risk of further cardiac events
Tests that may help diagnose a heart attack include...
Electrocardiogram (ECG or EKG)
Blood tests, assessing cardiac markers
Chest X-ray
Echocardiogram
Coronary catheterization (angiogram)
CT/MRI
Stress test
Source: American Heart Association, 2021
What is cardiac rehabilitation and why is it recommended?
A supervised program to improve cardiovascular health post-MI
Source: Thomas, R. J., et al. (2019). Home-based cardiac rehabilitation: A scientific statement from the American Association of Cardiovascular and Pulmonary Rehabilitation, the American Heart Association, and the American College of Cardiology. Journal of the American College of Cardiology, 74(1), 133–153. https://doi.org/10.1016/j.jacc.2019.03.008
Given Mr. L's age, what additional vaccination might he need beyond flu and COVID boosters?
Shingles or pneumonia vaccine
Source: CDC, 2024
https://www.cdc.gov/vaccines/hcp/imz-schedules/downloads/adult/adult-combined-schedule.pdf
Why is metoprolol tartrate typically prescribed BID for optimal blood pressure control in post-MI patients?
It is a short-acting beta-blocker, so dosing twice daily helps maintain consistent levels
Source: American Heart Association, 2021
What role does weight management play in post-MI recovery?
Helps reduce blood pressure, cholesterol, and cardiac workload
Why is A1c monitored even in non-diabetic post-MI patients?
To catch early signs of diabetes, as it’s a major risk factor for recurrent MI
Source: American Diabetes Association. (2023). Standards of medical care in diabetes—2023. Diabetes Care, 46(Suppl 1), S1–S154. https://doi.org/10.2337/dc23-Sint
Why should post-MI patients monitor their blood pressure at home?
Helps track response to treatment and detects hypertension early.
What is one reason Mr. L's beta-blocker might need adjusting?
Metoprolol tartrate is short-acting and may require BID dosing
Source: American Heart Association, 2021
Based on recent studies, name a newer medication added to the standard post-MI treatment plan for better outcomes.
SGLT2 inhibitors (if diabetes or heart failure is present)
Often used for DM, but now shows heart benefits.
Source: McGuire, D. K., Shih, W. J., Cosentino, F., et al. (2019). Association of SGLT2 inhibitors with cardiovascular and kidney outcomes in patients with type 2 diabetes: A meta-analysis. JAMA Cardiology, 4(7), 687–697. https://doi.org/10.1001/jamacardio.2020.4511
Which two vaccinations should older adults, including Mr. L receive as part of health maintenance?
Pneumonia and shingles vaccines
Source: CDC, 2024
https://www.cdc.gov/vaccines/hcp/imz-schedules/downloads/adult/adult-combined-schedule.pdf
What lab test should be routinely ordered to monitor kidney function in patients on ACE inhibitors or ARBs?
Blood Urea Nitrogen (BUN), serum creatinine, and electrolytes such as potassium
Source: Goyal, A., Cusick, A. S., & Thielemier, B. (2024). ACE inhibitors. In StatPearls [Internet]. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK430896/
Name a technique for managing stress, an essential part of post-MI care.
Mindfulness, yoga, or regular relaxation techniques
Mr. L’s blood pressure readings are elevated. Name a potential next step in managing his hypertension.
Increase the beta-blocker dose or consider adding an ACE inhibitor to achieve target blood pressure in patients with cardiovascular disease.
Source: Whelton, P. K., Carey, R. M., Aronow, W. S., et al. (2018). 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults. Journal of the American College of Cardiology, 71(19), e127–e248. https://doi.org/10.1016/j.jacc.2017.11.006