Med Surg Exam #2: Coronary Artery
Disease (Myocardial Infarction, EKG Basic
Info, & Other Diagnostic Tests & Labs)
(2/4) With 100% verified Questions and
Correct Answers with Rationales 2026
True or False: Angina is NOT a medical emergency. - Answer--TRUE!!!
What is Acute Coronary Syndrome (ACS)? Briefly explain. - Answer--ACS is an
EMERGENT situation characterized by an acute onset of myocardial ischemia which
results in an MI
What does Acute Coronary Syndrome (ACS) include? - Answer--- unstable angina
- Non-ST-segment elevation MI (NSTEMI)
- ST-segment-elevation MI (STEMI)
What is Unstable Angina? How does it relate to a Myocardial Infarction (MI)? Briefly
explain. - Answer--- also known as PREINFARCTION ANGINA -> will evolve into an
MI if not resolved/treated PROMPTLY
- atherosclerotic plaque ruptures -> decreased BF in coronary artery
- clot begins to form on TOP of coronary lesion, but coronary artery is NOT
completely occluded
- chest pain & other symptoms can be present
True or False: If a patient comes into the hospital with unstable angina, where is the
FIRST place we should be taking them? - Answer--TO THE CATH LAB DUH
Myocardial Infarction (MI): STEMI - Answer--- ST segment: time it takes for ventricle
to go from contracted to relaxes
- MI doesn't allow ventricle to rest
What procedure needs to occur IMMEDIATELY to ensure the BEST outcome for a
patient experiencing a STEMI? - Answer--PERCUNTANEOUS CORONARY
INTERVENTION (PCI)
True or False: A Myocardial Infarction (MI) is the death of myocardial tissue in
regions of the heart abruptly deprived of adequate blood supply die to reduce
coronary blood flow. - Answer--- TRUE!!!
,- part of the heart CAN & will die!
Briefly explain the patho of a Myocardial Infarction. - Answer--- unstable angina:
reduced BF in a coronary artery, usually due to rupture of atherosclerotic plaque;
referred to as "Pre-Infarction" & pt will probably have an MI w/o treatment
- MI: area of the myocardium is PERMANENTLY destroyed from complete occlusion
from a plaque rupture
What are other possible causes for an MI? - Answer--- vasospasm
- decreased O2 supply
- increased demand of O2
An area of infarction develops over minutes to hours. Briefly explain the process. -
Answer--- cells are deprived of O2
- ischemia develops
- cellular injury occurs
- lack of O2 results in death of cells (infarction
MI: Time is _____________? - Answer--MUSCLE
True or False: Ischemia from the heart muscle normally presents with similar signs &
symptoms across ALL patient populations. - Answer--- FALSE!!!
- may produce varying symptoms & severities, especially for women, diabetics, & the
elderly
What are possible varying S/S caused by ischemia of the heart muscle? - Answer--1.
sudden chest pain (despite rest & meds) ranging from mild indigestion to deep
substernal heaviness to feelings of impending death
2. may radiate to neck, lower jaw, inner aspects of arms (usually left arm/shoulder)
3. weakness
4. diaphoresis, dizziness
5. SOB
6. N/V, pallor
7. tachycardia & tachypnea (SNS -> sometimes only present for a short time)
True or False: S/S of an MI may VARY in women. - Answer--- TRUE!!!
- women may have fatigue & THEN rest pain
- men are the OPPOSITE
What are the 3 KEY FACTORS that the outcome of an MI is based on? - Answer--1.
size of damage area
2. location of the infarct
3. presence of collateral circulation: if collateral circulation is good, a person can
experience 100% occlusion with minimal damage
, Briefly explain how an infarct of the Left Anterior Descending Artery impacts the
outcome of an MI. - Answer--- ANTERIOR MI
- frequently accompanied by HEART FAILURE & may produce some degree of
HEART BLOCK
Briefly explain how a Right Coronary Artery Occlusion impacts the outcome of an Mi.
- Answer--- INFERIOR MI
- frequently have TEMPORARY HEART BLOCKS & a LOT of nausea
Briefly explain how an infarct of the Circumflex artery impacts the outcome of an MI.
- Answer--lateral wall & some of posterior wall
What are the 3 categories of diagnostic tests done to rule out an MI? - Answer--1.
patient history
2. ECG
3. lab testing
Diagnostic Tests to Rule Out MI: Patient History - Answer--- arguably one of the
MOST important tests
- description of presenting symptoms
- PQRST (chest pain assessment)
- history of previous history & family history
- ex: what where they doing when it happened?
Diagnostic Tests to Rule Out MI: ECG - Answer--- obtain IMMEDIATELY
- location, evolution, & resolution
- EKF should be hooked up & done within 10 MINUTES of arrival to the hospital
Diagnostic Tests to Rule Out MI: Lab Testing - Answer--- Troponin
- Serum Enzyme elevations
- elevated WBC count (like velcro; go to area of injury & STICK, which is why WBC
count is so high)
True or False: Overall, getting a patient with an MI to the cath lab ASAP is the BEST
possibly outcome for your patient. - Answer--TRUE!!!
Myocardial Infarction (MI): ECG - Answer--- must be obtained within 10 MINUTES of
reported chest pain or arrival to ED
- ECG changes occurring with an MI are seen in the leads that view the surface of
the heart
- ECG changes primarily occur within 2-12 hours but may take 72-96 hours
Disease (Myocardial Infarction, EKG Basic
Info, & Other Diagnostic Tests & Labs)
(2/4) With 100% verified Questions and
Correct Answers with Rationales 2026
True or False: Angina is NOT a medical emergency. - Answer--TRUE!!!
What is Acute Coronary Syndrome (ACS)? Briefly explain. - Answer--ACS is an
EMERGENT situation characterized by an acute onset of myocardial ischemia which
results in an MI
What does Acute Coronary Syndrome (ACS) include? - Answer--- unstable angina
- Non-ST-segment elevation MI (NSTEMI)
- ST-segment-elevation MI (STEMI)
What is Unstable Angina? How does it relate to a Myocardial Infarction (MI)? Briefly
explain. - Answer--- also known as PREINFARCTION ANGINA -> will evolve into an
MI if not resolved/treated PROMPTLY
- atherosclerotic plaque ruptures -> decreased BF in coronary artery
- clot begins to form on TOP of coronary lesion, but coronary artery is NOT
completely occluded
- chest pain & other symptoms can be present
True or False: If a patient comes into the hospital with unstable angina, where is the
FIRST place we should be taking them? - Answer--TO THE CATH LAB DUH
Myocardial Infarction (MI): STEMI - Answer--- ST segment: time it takes for ventricle
to go from contracted to relaxes
- MI doesn't allow ventricle to rest
What procedure needs to occur IMMEDIATELY to ensure the BEST outcome for a
patient experiencing a STEMI? - Answer--PERCUNTANEOUS CORONARY
INTERVENTION (PCI)
True or False: A Myocardial Infarction (MI) is the death of myocardial tissue in
regions of the heart abruptly deprived of adequate blood supply die to reduce
coronary blood flow. - Answer--- TRUE!!!
,- part of the heart CAN & will die!
Briefly explain the patho of a Myocardial Infarction. - Answer--- unstable angina:
reduced BF in a coronary artery, usually due to rupture of atherosclerotic plaque;
referred to as "Pre-Infarction" & pt will probably have an MI w/o treatment
- MI: area of the myocardium is PERMANENTLY destroyed from complete occlusion
from a plaque rupture
What are other possible causes for an MI? - Answer--- vasospasm
- decreased O2 supply
- increased demand of O2
An area of infarction develops over minutes to hours. Briefly explain the process. -
Answer--- cells are deprived of O2
- ischemia develops
- cellular injury occurs
- lack of O2 results in death of cells (infarction
MI: Time is _____________? - Answer--MUSCLE
True or False: Ischemia from the heart muscle normally presents with similar signs &
symptoms across ALL patient populations. - Answer--- FALSE!!!
- may produce varying symptoms & severities, especially for women, diabetics, & the
elderly
What are possible varying S/S caused by ischemia of the heart muscle? - Answer--1.
sudden chest pain (despite rest & meds) ranging from mild indigestion to deep
substernal heaviness to feelings of impending death
2. may radiate to neck, lower jaw, inner aspects of arms (usually left arm/shoulder)
3. weakness
4. diaphoresis, dizziness
5. SOB
6. N/V, pallor
7. tachycardia & tachypnea (SNS -> sometimes only present for a short time)
True or False: S/S of an MI may VARY in women. - Answer--- TRUE!!!
- women may have fatigue & THEN rest pain
- men are the OPPOSITE
What are the 3 KEY FACTORS that the outcome of an MI is based on? - Answer--1.
size of damage area
2. location of the infarct
3. presence of collateral circulation: if collateral circulation is good, a person can
experience 100% occlusion with minimal damage
, Briefly explain how an infarct of the Left Anterior Descending Artery impacts the
outcome of an MI. - Answer--- ANTERIOR MI
- frequently accompanied by HEART FAILURE & may produce some degree of
HEART BLOCK
Briefly explain how a Right Coronary Artery Occlusion impacts the outcome of an Mi.
- Answer--- INFERIOR MI
- frequently have TEMPORARY HEART BLOCKS & a LOT of nausea
Briefly explain how an infarct of the Circumflex artery impacts the outcome of an MI.
- Answer--lateral wall & some of posterior wall
What are the 3 categories of diagnostic tests done to rule out an MI? - Answer--1.
patient history
2. ECG
3. lab testing
Diagnostic Tests to Rule Out MI: Patient History - Answer--- arguably one of the
MOST important tests
- description of presenting symptoms
- PQRST (chest pain assessment)
- history of previous history & family history
- ex: what where they doing when it happened?
Diagnostic Tests to Rule Out MI: ECG - Answer--- obtain IMMEDIATELY
- location, evolution, & resolution
- EKF should be hooked up & done within 10 MINUTES of arrival to the hospital
Diagnostic Tests to Rule Out MI: Lab Testing - Answer--- Troponin
- Serum Enzyme elevations
- elevated WBC count (like velcro; go to area of injury & STICK, which is why WBC
count is so high)
True or False: Overall, getting a patient with an MI to the cath lab ASAP is the BEST
possibly outcome for your patient. - Answer--TRUE!!!
Myocardial Infarction (MI): ECG - Answer--- must be obtained within 10 MINUTES of
reported chest pain or arrival to ED
- ECG changes occurring with an MI are seen in the leads that view the surface of
the heart
- ECG changes primarily occur within 2-12 hours but may take 72-96 hours
