PCCN Review – Cardiac 2024-2025
PREP TEST BANK EXAM 2 2024-2025 WITH 450 plus
QUESTIONS AND CORRECT DETAILED ANSWERS (100%
CORRECT ANSWERS) PCCN (NEWLY UPDATED 2024-
2025
Unstable Angina
Change in the pattern of angina; Increased pain; not responsive
to first Nitro tab; Can persist >5 min; Occurs more Freq; lasts
longer; Occurs at rest --> Indicates Rupture of plaque forming
thrombus = MI
Variant Angina
Results from spasms of the Coronary arteries (c) or (s) plaque;
r/t smoking/etoh/stimulant rxs; elevated STs; usually occurs at
same time each day; occurs at rest --> Tx with Nitro & Ca++ Ch
Blockers
Calcium Channel Blocker
,Blocks Ca+ flow = Decreased Contraction + Decreased
Conductivity = Decreased Demand for O2 --> Tx for angina &
arrhythmias.
-- Side Fx = Decreased BP, Brady<3, Poss AV block, HA, nausea,
poss perph edema
Myocardial Infarction
Hearts Demand for O2 > Supply of O2 - usually from ACS
(plaque or thrombus) - Can also come from
vasoconstriction/acute blood loss/decreased O2/cocaine -
Usually occurs in stages.
Zone of Infarction
Area of tissue necrosis = cells destroyed and replaced with scar
tissue/ irreversible damage happens after complete occlusion
for 15-20 mins
,Q-wave MI
Wider and deeper abnormal Qwaves especially in the early am
(because of adrenergic activity); Infarction prolonged & turns
into necrosis
- Indicates transmural necrosis in most cases from coronary
complete occlusion (80%-90%) - Mortality in 10% of cases.
Non-Q-wave MI
ST depressions and reversible within a few days; reperfusion
occurs spontaneously so infarct size is smaller; contraction
necrosis & scarring from extra contraction for reperfusion
common; complete coronary occlusion in only (20%-30%) -
Mortality in only 2%-3% of cases - Most likely will have another
MI in 2 years.
MI Symptoms
Crushing CP - may radiate; palpitations; HTN or HypoTN; EKG
changes; Dyspnea/SOB; Pulm edema; N+V; decreased urinary
output; clammy/pale/cold; dependent edema; Change in LOC
, MI Labs
- ECG = St elevation or Wide Qwave
- CK = peaks in 24 hrs for Qwave MI; peaks 12 hrs for non-
Qwave MI
- Myoglobin = heme protein that carries O2 - no increase = not
an MI
- Troponin = Can remain elevated for 3 weeks
Papillary Muscle Rupture
A direct result from MI = When the muscles that control the
atria/vent valves (TV and MV) rupture = regurgitation or dysfxn;
leads to vent failure due to backflow; MV regurg can lead to
pulm efema and cardiogenic shock - diagnose with ECHO.
Myocarditis
PREP TEST BANK EXAM 2 2024-2025 WITH 450 plus
QUESTIONS AND CORRECT DETAILED ANSWERS (100%
CORRECT ANSWERS) PCCN (NEWLY UPDATED 2024-
2025
Unstable Angina
Change in the pattern of angina; Increased pain; not responsive
to first Nitro tab; Can persist >5 min; Occurs more Freq; lasts
longer; Occurs at rest --> Indicates Rupture of plaque forming
thrombus = MI
Variant Angina
Results from spasms of the Coronary arteries (c) or (s) plaque;
r/t smoking/etoh/stimulant rxs; elevated STs; usually occurs at
same time each day; occurs at rest --> Tx with Nitro & Ca++ Ch
Blockers
Calcium Channel Blocker
,Blocks Ca+ flow = Decreased Contraction + Decreased
Conductivity = Decreased Demand for O2 --> Tx for angina &
arrhythmias.
-- Side Fx = Decreased BP, Brady<3, Poss AV block, HA, nausea,
poss perph edema
Myocardial Infarction
Hearts Demand for O2 > Supply of O2 - usually from ACS
(plaque or thrombus) - Can also come from
vasoconstriction/acute blood loss/decreased O2/cocaine -
Usually occurs in stages.
Zone of Infarction
Area of tissue necrosis = cells destroyed and replaced with scar
tissue/ irreversible damage happens after complete occlusion
for 15-20 mins
,Q-wave MI
Wider and deeper abnormal Qwaves especially in the early am
(because of adrenergic activity); Infarction prolonged & turns
into necrosis
- Indicates transmural necrosis in most cases from coronary
complete occlusion (80%-90%) - Mortality in 10% of cases.
Non-Q-wave MI
ST depressions and reversible within a few days; reperfusion
occurs spontaneously so infarct size is smaller; contraction
necrosis & scarring from extra contraction for reperfusion
common; complete coronary occlusion in only (20%-30%) -
Mortality in only 2%-3% of cases - Most likely will have another
MI in 2 years.
MI Symptoms
Crushing CP - may radiate; palpitations; HTN or HypoTN; EKG
changes; Dyspnea/SOB; Pulm edema; N+V; decreased urinary
output; clammy/pale/cold; dependent edema; Change in LOC
, MI Labs
- ECG = St elevation or Wide Qwave
- CK = peaks in 24 hrs for Qwave MI; peaks 12 hrs for non-
Qwave MI
- Myoglobin = heme protein that carries O2 - no increase = not
an MI
- Troponin = Can remain elevated for 3 weeks
Papillary Muscle Rupture
A direct result from MI = When the muscles that control the
atria/vent valves (TV and MV) rupture = regurgitation or dysfxn;
leads to vent failure due to backflow; MV regurg can lead to
pulm efema and cardiogenic shock - diagnose with ECHO.
Myocarditis
