AMLS Cardiac Emergencies 1 — Questions and Answers
Question 1: Which ECG finding is most consistent with an acute ST-elevation myocardial infarction (STEMI) in the inferior leads?
- ST elevation in leads II, III, and aVF (Correct answer)
- ST depression in leads V1-V4
- Prolonged QT interval
- Right bundle branch block
Correct answer: ST elevation in leads II, III, and aVF
Inferior STEMI presents with ST elevation in leads II, III, and aVF, reflecting ischemia of the right coronary artery territory.
Question 2: A patient presents with sudden-onset tearing chest pain radiating to the back. Which condition should be suspected first?
- Acute aortic dissection (Correct answer)
- Tension pneumothorax
- Pericarditis
- Pulmonary contusion
Correct answer: Acute aortic dissection
Tearing or ripping chest pain radiating to the back is the classic presentation of acute aortic dissection.
Question 3: What is the primary goal of early reperfusion therapy in STEMI management?
- Restore coronary blood flow to salvage myocardium (Correct answer)
- Reduce systemic blood pressure
- Prevent ventricular hypertrophy
- Decrease heart rate
Correct answer: Restore coronary blood flow to salvage myocardium
Early reperfusion aims to restore coronary blood flow to limit infarct size and salvage viable myocardium.
Question 4: Which rhythm is most commonly the initial rhythm seen in sudden cardiac arrest due to cardiac etiology?
- Ventricular fibrillation (Correct answer)
- Asystole
- Pulseless electrical activity
- Atrial fibrillation
Correct answer: Ventricular fibrillation
Ventricular fibrillation is the most common initial rhythm in sudden cardiac arrest of cardiac origin and is shockable.
Question 5: A patient with chest pain has a 12-lead ECG showing new left bundle branch block. How should this be managed?
- Treat as STEMI equivalent and activate cath lab (Correct answer)
- Administer aspirin only and monitor
- Discharge with cardiology follow-up
- Perform immediate cardioversion
Correct answer: Treat as STEMI equivalent and activate cath lab
New LBBB with chest pain is treated as a STEMI equivalent, requiring emergent cardiac catheterization.
Question 6: Beck's triad (hypotension, muffled heart sounds, and JVD) is associated with which cardiac emergency?
- Cardiac tamponade (Correct answer)
- Acute MI
- Right-sided heart failure
- Hypertensive emergency
Correct answer: Cardiac tamponade
Beck's triad of hypotension, muffled heart sounds, and jugular venous distension classically indicates cardiac tamponade.
AMLS Cardiac Emergencies 1
Which ECG finding is most consistent with an acute ST-elevation myocardial infarction (STEMI) in the inferior leads?