Distinguishing Myocardial Infarction from Unstable Angina

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1) Which of the following is used to distinguish the diagnosis of MI (Myocardial Infarction) from that of Unstable angina?
a) Serum levels of Cardiac Biomarkers (Troponin, CK-MB)
b) Electrocardiograph (ECG) test
c) The presence of S4 Heart sound
d) Pain lasts for less than 5 minutes in an MI
Rationale
The correct answer is A because serum levels of cardiac biomarkers such as troponin and CK-MB are used for the final diagnosis of Myocardial infarction (STEMI, NSTEMI). Electrocardiograph (ECG) testing is used to distinguish between acute coronary syndromes with ST elevation on the ECG (STEMI) and those without an ST elevation on the ECG (Non St elevation and NSTEMI). The presence of S4 Heart sound may be indicative of myocardial ischemia due to the lack of oxygen supply to the heart muscle cells, also, it may be present in both MI and unstable angina hence can not be used to distinguish diagnosis. Pain duration is not very specific for diagnosis of ACS

2) …show more content…

a) Decreasing myocardial oxygen demand
b) Decreasing myocardial oxygen supply
c) Increasing myocardial oxygen demand
d) Increasing myocardial oxygen supply
Rationale
The answers are A&D. Decreasing myocardial oxygen demand (heart rate control, preload/after load reduction) and Increasing myocardial oxygen supply (perfusion) are essential in the treatment of MI.

3) Which of the following is NOT part of ECG Changes that is associated with MI?
a) ST elevation
b) Inverted T wave
c) Shortened PR wave length
d) Abnormally deep or wide Q

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