MYOCARDIAL INFARCT QUIZ

18 November 2020

1. Which of the following is most accurate regarding the presentation of MI?

A. In some individuals, the only reported symptom of MI is epigastric pain
B. Most MIs occur in the evening, typically after the final meal of the day
C. Pain that radiates above the chest and into the neck, shoulder, and jaws strongly suggests
a diagnosis other than MI
D. A positive family history requires at least two male or female relatives aged 60 years or
younger who experienced an MI

2. Which of the following is most accurate regarding the physical examination findings
associated with MI?
A. In patients with acute inferior-wall MI with right ventricular involvement, distention of
neck veins is commonly described as a sign of failure of the right ventricle
B. Decreased blood pressure excludes a diagnosis of acute MI
C. Fever associated with MI typically occurs after the initial 48 hours, and increased body
temperature is typically correlated with decreased left ventricular function
D. A new mitral regurgitation murmur (typically holosystolic near the apex) in patients with
MI indicates the presence of left bundle branch block

3. Which of the following is most accurate regarding the definition of MI, according to the Joint
European Society of Cardiology/ACC/American Heart Association/World Heart Federation
Task Force?
A. In patients with MI, myocardial injury is only considered acute if there is a rise in high-
sensitivity cardiac troponin (cTn) levels, as opposed to a fall in cTn levels
B. Identification of a coronary thrombus by angiography distinguishes type 1 and type 2 MI
C. Coronary intervention-related MI requires cTn values > 10 times the 99th percentile
upper reference limit
D. Patients with MI may have decreased cTn values and marked increases in ejection
fraction due to sepsis caused by endotoxin

4. Which of the following is recommended for the management of patients with acute MI
during the COVID-19 pandemic, according to a consensus statement from the Society for
Cardiovascular Angiography and Interventions, the ACC, and the American College of
Emergency Physicians?
A. A fibrinolysis-first approach is recommended for all patients who present with ST-
segment elevation MI (STEMI) during the COVID-19 pandemic
B. Direct transport of patients with STEMI to the cardiac catheterization laboratory (CCL) is
recommended during the COVID-19 pandemic, as opposed to initial assessment in the
emergency department
C. Primary percutaneous coronary intervention (PCI) remains the standard of care for
patients with STEMI presenting to PCI centers within 90 minutes of first medical contact
during the COVID-19 pandemic
 D. All patients with COVID-19 who have ST elevation with or without an acute coronary
occlusion should undergo reperfusion strategies and/or advanced mechanical support

5. Which of the following is most commonly recognized as an absolute contraindication to

fibrinolytic therapy in patients with STEMI?
A. Prior ischemic stroke within the past 6 month
B. Systolic blood pressure > 160 mm Hg or diastolic blood pressure > 100 mm Hg
C. Suspected aortic dissection
D. Current menses

 Myocardial Infarction
 Metabolic Surgery Post-MI Trims CV Events Long Term
 NACMI: Clear Benefit With PCI in STEMI COVID-19 Patients