When are the coronary arteries perfused? - answer✔during diastole
Where is the aortic valve auscultated? - answer✔2nd intercostal space, right sternal border
Where is the pulmonic valve auscultated? - answer✔2nd intercostal space, left sternal border
Where is the tricuspid valve auscultated? - answer✔4th intercostal space, left sternal border
Where is the mitral valve auscultated? - answer✔5th intercostal space, left midclavicular line
Which heart sound indicates the closure of the mitral & tricuspid valves? - answer✔S1
What does the S1 heart sound indicate? - answer✔systole
Which heart sound indicates the closure of the pulmonic and aortic valves? - answer✔S2
What does the s2 heart sound indicate? - answer✔diastole
What are some causes of auscultating and s3 (ventricular gallop) heart sound? - answer✔kids
(normal)
high cardiac output patient
3rd trimester pregnancy
cardiomyopathy
ventricular septal defect
mitral or tricuspid regurgitation
What are some causes of auscultating and s4 (atrial gallop) heart sound? - answer✔ischemia
HTN
pulmonary stenosis
ALL RIGHTS RESERVED.
CAD
aortic stenosis
left ventricular hypertrophy
A split s1 sound is when the mitral valve closes before the tricuspid valve. What might this
indicate? - answer✔RBBB
PVCs
ventricular pacing
A split s2 sound is when the aortic valve closes before the pulmonic valve. What might this
indicate? - answer✔overfilled right ventricle
atrial septal defect
In ACS, there is an imbalance of what? - answer✔oxygen supply & demand
What are non-modifiable ACS risk factors? - answer✔age, family history, gender, race
What are modifiable ACS risk factors? - answer✔smoking, diet, HLD, obesity, inactivity, HTN,
DM
If a patient comes in complaining of chest pain, what lab test can be expected to be drawn? -
answer✔troponin
What does OLD CART stand for when assessing chest pain? - answer✔Onset
Location
Duration
Characteristics
Associated s/s
Relieving Factors
Treatment
What type of angina is considered a precursor to an MI? - answer✔unstable
What type of angina has pain that stops when patient rests? - answer✔stable
What type of angina occurs at rest and could potentially show EKG changes? -
answer✔variant/prinzmetal
ALL RIGHTS RESERVED.
All types of angina can benefit from NTG if pain continues. Which type of angina would also
indicate the potential need for antiplatelet therapy to be started? - answer✔Unstable angina
All types of angina can benefit from NTG if pain continues. Which type of angina would you
expect this provider to order a calcium channel blocker as well? - answer✔variant/prinzmetal
angina
A patient presents to the ED with chest pain that started while watching TV and has persisted
for 2 hours. Pt's EKG appears normal, but troponin comes back elevated. Based on this, what is
going on with the patient? - answer✔NSTEMI/non-ST elevation ACS
What would you expect treatment to be for a patient with an NSTEMI? - answer✔PCI, not
necessarily emergent
Your patient is complaining of sudden sharp chest pain that is radiating to the back and left
arm. Patient is noted to be diaphoretic upon assessment. When obtaining an EKG you noticed
ST elevation in multiple leads. What type of ACS is happening? - answer✔STEMI
Which ACS is considered an emergency that will require immediate cath lab intervention? -
answer✔STEMI
ST depression indicates what? - answer✔ischemia
partial occlusion of coronary arteries
ST elevation indicates what? - answer✔myocardial injury
complete occlusion of a coronary artery
What are contiguous leads? - answer✔lateral: I, aVL, v5, v6
inferior: II, III, aVF
anterior/septal: v1-v4
What is the first medicine you expect to give to a patient who has an emergent STEMI? -
answer✔aspirin, chewed 81mg-325mg
What other treatments may be given to a patient with an emergent STEMI? - answer✔NTG,
morphine, and oxygen
What medications do you expect a post PCI patient to be on? - answer✔aspirin, p2y12
inhibitor, beta blocker, statin, ACEI/ARB
When doing teaching with a patient, what would you tell the patient when they ask how long
they will be on brilinta? - answer✔at least 1 year
3|Page
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