Study your flashcards anywhere!

Download the official Cram app for free >

  • Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off

How to study your flashcards.

Right/Left arrow keys: Navigate between flashcards.right arrow keyleft arrow key

Up/Down arrow keys: Flip the card between the front and back.down keyup key

H key: Show hint (3rd side).h key

A key: Read text to speech.a key


Play button


Play button




Click to flip

41 Cards in this Set

  • Front
  • Back
typical chest pain associated with coronary artery disease
True or False:
A patient with angina may ultimately go on to experience an infarction or may remain stable for many years.
An EKG taken during an angina attack will show ______ or ______.
ST depression

T wave inversion
difference between angina and non-Q wave infarction changes
angina: ST segments return to baseline after the attack has subsided

non-Q infarct: ST segments remain down for at least 48 hours
Two ways to distinguish between ST segment depression of angina and that of non-Q wave infarctions.
(1) clinical picture

(2) time course
Why might cardiac enzymes be helpful in differentiating between non-Q infarctions and angina?
they will be elevated with infarction but not with uncomplicated angina
Name the one type of angina that is associated with ST segment elevation.
Prinzmetal's Angina
Name a key difference in the onset of Prinzmetal's Angina versus typical angina.
typical: brought on by exertion

Prinzmetal's: any time; commonly the result of coronary artery spasm
What does ST elevation in Prinzmetal's angina typically reflect?
reversible transmural injury
Describe the ST segments of Prinzmetal's Angina and how they compare to infarction.
The contours of the ST segments often will not have the rounded, domed appearance of true infarction.

The ST segments will return quickly to baseline when the patient is given antianginal medication (nitro).
What are the two groups of Prinzmetal's angina?
(1) no atheroscelrosis; spasm only

(2) some atherosclerosis; may or may not have superimposed spasm
When may ST segment elevation be seen in ischemic cardiac disease?
May be seen with an evolving transmural infarction or with Prinzmetal's angina.
Describe when ST segment depression may be seen in ischemic cardiac disease.
May be seen with typical angina or with a non-Q wave infarction.
Chest pain patients who present with acute ST segment elevation most likely need either _____ or _____.

Chest pain patients with ST segment depression or no ST segment changes may be managed ______, and need _____ evaluation if they are at high risk (high enzymes, prior angioplasty or bypass).

The electrocardiographic picture of an evolving myocardial infarction typically includes ______ changes and ______.
ST changes
new Q waves
How would an underlying condition that distorts the ST segment and QRS complex affect EKG diagnosis of an infarction.
in would make EKG diagnosis of infarction impossible
Name two conditions that render EKG interpretation of infarction impossible.
WPW syndrome
left bundle branch block
True or False:
It is impossible to diagnose an infarction in the presence of right bundle branch block.
Right bundle branch block is less of a concern than left because most infarctions involve the left ventricle.
Rule: In the presence of ______ or ______, the diagnosis of a myocardial infarction cannot be made by EKG. This caveat includes patients with a ______ on their EKG because of ______ pacing.

In patients with WPW, the delta waves are often ______ in the inferior leads. This pattern is often referred to as a _______ because the delta waves may resemble Q waves.

psuedoinfarct pattern
In a WPW psuedoinfarct pattern, what remaining clue can distinguish WPW from an infarction on EKG?
the short PR interval
True or False:
WPW and infarction sometimes look similar on EKG.
a noninvasive method of assessing the presence and severity of coronary artery disease
stress test
another term for "stress test"
exercise tolerance testing
Electron beam or rapid CT scanning of the heart can give a ______ that indicates the extent of coronary artery disease.
calcium score
In stress testing, a patient is hooked up to an EKG and placed on a ______.
In stress testing, the incline of the treadmill is increased until one of the following four things occur:
(1) the patient cannot continue for whatever reason

(2) the patient's maximal heart rate is achieved

(3) symptoms supervene

(4) significant changes are seen on EKG
Stress testing causes a ______ and _______ increase in the patient's heart rate and systolic blood pressure.

In stress testing, this is the product of the patient's blood pressure multiplied by his heart rate.
double product
In stress testing, the double product is a good measure of this.
myocardial oxygen consumption
True or False:
Sometimes stress tests induce EKG changes associated with ischemia.
In a stress test positive diagnosis of coronary artery disease, the EKG will reveal ______.
ST segment depression
True or False:
T wave changes on stress test diagnose coronary artery disease.
T wave changes are too nonspecific to have any meaning in this setting.
In a stress test setting, ST segment depression of greater than ______ that is ______ or ______ and persists for more than ______ seconds is suggestive of coronary artery disease.
1 mm

down sloping

True or False:
Up-sloping ST segments almost always signify coronary artery disease.
Occasionally, up-sloping ST segments may signify coronary artery disease, but the number of false positive results is very high.
The earlier in a stress test that ST segment depression occurs, the ______ the likelihood of coronary artery disease.
True or False:
The earlier changes occur on a stress test, the greater the likelihood that the left main coronary artery or several coronary arteries are involved.
True or False:
Stress test false positives and false negatives do occur.
The incidence of false-positive and false-negative results is dependent on the patient population that is being tested.
indications for stress testing include (list three)
(1) chest pain

(2) recent infarct

(3) over 40 with risk factors or desire to begin a new exercise program
contraindications for stress testing include (list six)
(1) acute systemic illness

(2) severe aortic stenosis

(3) uncontrolled CHF

(4) severe hypertension

(5) angina at rest

(6) significant arrhythmia