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Acute Coronary Syndrome Quiz
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Which of the following conditions is included within the definition of acute coronary syndrome?
- A Dilated cardiomyopathy You picked ✕
- B Stable angina You picked ✕
- C Aortic stenosis You picked ✕
- D ST-elevation myocardial infarction You picked ✓
- E Acute pericarditis You picked ✕
Correct!
Incorrect
The answer is D: ST-elevation myocardial infarction
Explanation
Why D is correct
See Acute Coronary Syndrome. Option D is correct because acute coronary syndrome (ACS) is the name for a group of conditions caused by a sudden reduction in blood flow to the heart, most often because an atherosclerotic plaque (a fatty deposit in the artery wall) ruptures and a clot forms on it. The three conditions in the group are unstable angina, non-ST-elevation myocardial infarction (NSTEMI) and ST-elevation myocardial infarction (STEMI). In a STEMI a coronary artery is completely blocked, so the whole thickness of the heart muscle supplied by that artery is injured (a transmural infarct), and the ECG shows ST elevation. This is why STEMI belongs in the group and is treated as an emergency. The group is separated from stable angina because in stable angina the plaque is stable and the narrowing causes pain only when the demand for oxygen rises, for example on exertion, and it goes away with rest.
- Definition: acute coronary syndrome is a sudden reduction in coronary blood flow, usually from plaque rupture with clot formation.
- Members: unstable angina, NSTEMI and STEMI.
- STEMI: complete blockage of a coronary artery causes a transmural infarct with ST elevation on the ECG.
- Stable angina: the plaque is stable and pain comes only on exertion, so it is not part of the group.
Of the options, only STEMI results from a sudden loss of coronary flow.
Why the other options are incorrect
- A. Dilated cardiomyopathy: Dilated cardiomyopathy is a primary disease of the heart muscle that causes the ventricles to dilate. It is not caused by a sudden loss of coronary blood flow. Your answer
- B. Stable angina: Stable angina comes from a fixed narrowing of a coronary artery that causes pain only when demand rises. The plaque is stable, so it is not an acute coronary syndrome. Your answer
- C. Aortic stenosis: Aortic stenosis is a narrowing of a heart valve that obstructs outflow. It is a valve problem, not a sudden coronary artery event. Your answer
- E. Acute pericarditis: Acute pericarditis is inflammation of the pericardium and causes chest pain by a different mechanism. It is not caused by a coronary artery blockage. Your answer
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More questions from this set. Start the quiz to answer them and see each explanation.
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1
In a patient with acute ischaemic chest pain, which ECG change is most characteristic of a STEMI pattern?
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2
A 54-year-old woman presents to the emergency department with central chest pain radiating to her left arm that began 2 hours ago. Her ECG shows T wave inversion in the anterior leads. Which investigation result would most strongly support a diagnosis of NSTEMI rather than unstable angina?
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