ALS CERTIFICATION GUIDE 2026 VERIFIED
ANSWERS READY
◉ Unstable angina. Answer: Ischaemic chest pain not provoked by
exertion but without myocardial infarction
◉ ST-elevation myocardial infarction (STEMI). Answer: Transmural
myocardial infarction resulting in ST elevation in contiguous ECG
leads
◉ Anterior ECG leads. Answer: V2, V3, V4
◉ Non ST-elevation myocardial infarction (NSTEMI). Answer: Non-
transmural myocardial infarction resulting in ST depression and/or T
wave inversion in contiguous ECG leads
◉ Inferior ECG leads. Answer: II, III, aVF
◉ Lateral ECG leads. Answer: I, aVL, V5, V6
◉ Septal ECG leads. Answer: V1, V2
◉ Immediate treatment for all suspected acute coronary syndrome.
Answer: 1. Aspirin 300mg
, 2. Nitrate
3. Morphine
4. Oxygen ONLY IF HYPOXIC
◉ Further treatment for suspected unstable angina or NSTEMI.
Answer: Prasugrel/ticagrelor/clopidogrel
PLUS Fondaparinux/LMWH
◉ What can be used for myocardial protection in unstable angina or
NSTEMI?. Answer: Beta-blocker
◉ First-line further treatment for suspected STEMI. Answer: PCI
◉ Second-line further treatment for suspected STEMI. Answer:
Fibrinolysis
◉ Left bundle branch block on ECG. Answer: Wide QRS in V5 and
V6
Large R wave in lead 1
Negative wave in lead V1
◉ First-line management for polymorphic VT/torsades de pointes.
Answer: Magnesium 2g over 10 minutes
ANSWERS READY
◉ Unstable angina. Answer: Ischaemic chest pain not provoked by
exertion but without myocardial infarction
◉ ST-elevation myocardial infarction (STEMI). Answer: Transmural
myocardial infarction resulting in ST elevation in contiguous ECG
leads
◉ Anterior ECG leads. Answer: V2, V3, V4
◉ Non ST-elevation myocardial infarction (NSTEMI). Answer: Non-
transmural myocardial infarction resulting in ST depression and/or T
wave inversion in contiguous ECG leads
◉ Inferior ECG leads. Answer: II, III, aVF
◉ Lateral ECG leads. Answer: I, aVL, V5, V6
◉ Septal ECG leads. Answer: V1, V2
◉ Immediate treatment for all suspected acute coronary syndrome.
Answer: 1. Aspirin 300mg
, 2. Nitrate
3. Morphine
4. Oxygen ONLY IF HYPOXIC
◉ Further treatment for suspected unstable angina or NSTEMI.
Answer: Prasugrel/ticagrelor/clopidogrel
PLUS Fondaparinux/LMWH
◉ What can be used for myocardial protection in unstable angina or
NSTEMI?. Answer: Beta-blocker
◉ First-line further treatment for suspected STEMI. Answer: PCI
◉ Second-line further treatment for suspected STEMI. Answer:
Fibrinolysis
◉ Left bundle branch block on ECG. Answer: Wide QRS in V5 and
V6
Large R wave in lead 1
Negative wave in lead V1
◉ First-line management for polymorphic VT/torsades de pointes.
Answer: Magnesium 2g over 10 minutes