Ischemia and Infarction: EKG Interpretation for Medical Assistants

Question 1

What is the primary cause of a heart attack (myocardial infarction)?

Accepted Answer

Progressive narrowing of the coronary arteries due to plaque buildup

Answer

Sudden constriction of coronary arteries, reducing blood flow to the heart

Answer

Weakened heart muscle due to disease or infection, impairing pumping ability

Answer

Irregular heart rhythms, such as arrhythmias or palpitations, leading to inadequate heart function

Question 2

Which of these modifiable behaviors can raise the risk of ischemia and infarction?

Accepted Answer

Smoking

Accepted Answer

Physical inactivity

Answer

Age

Answer

Family history

Question 3

Which of the following is a protective factor against ischemic heart disease?

Accepted Answer

Regular exercise

Answer

Hypertension

Answer

Hyperlipidemia

Answer

Smoking

Question 4

Which of the following is a major risk factor for developing ischemia and infarction?

Accepted Answer

Smoking

Answer

Regular exercise

Answer

Healthy diet

Answer

Low stress levels

Question 5

What is the most common cause of ST-elevation myocardial infarction (STEMI)?

Accepted Answer

Atherosclerotic plaque rupture or erosion

Answer

Sustained coronary artery spasm

Answer

Severe myocarditis

Answer

Hypertrophic cardiomyopathy

Question 6

For a patient experiencing chest pain, which EKG finding is the strongest indicator of a transmural myocardial infarction?

Accepted Answer

ST-segment elevation in multiple leads

Answer

T-wave inversion in leads V1-V3

Answer

Q waves in leads I and aVL

Answer

Prolonged PR interval

Question 7

A 65-year-old male presents to the emergency room with chest pain. His EKG shows ST-segment elevation in leads V1 through V4. What is the most likely diagnosis?

Accepted Answer

Acute myocardial infarction

Answer

Unstable angina

Answer

Pericarditis

Answer

Myocarditis

Question 8

What is a risk factor for myocardial ischemia?

Accepted Answer

Hypertension

Accepted Answer

Smoking

Answer

Regular exercise

Answer

Low cholesterol levels

Question 9

In EKG interpretation, what's a key indicator of acute ST-elevation myocardial infarction (STEMI)?

Accepted Answer

ST-segment elevation of 1 mm or more in at least two adjacent leads

Answer

ST-segment depression in multiple leads

Answer

T-wave inversion in the inferior leads

Answer

Prolonged PR interval

Question 10

Which factor provides protection against developing myocardial ischemia?

Accepted Answer

Regular exercise

Answer

Diabetes

Answer

Smoking

Answer

Obesity

Question 11

What is the main cause of myocardial ischemia?

Accepted Answer

Atherosclerosis

Answer

High blood pressure

Answer

Diabetes

Answer

Smoking

Question 12

Which of the following is a factor that helps protect against ischemia and infarction?

Accepted Answer

Regular exercise

Answer

Diabetes

Answer

Smoking

Answer

Hypertension

Question 13

Which EKG finding is a strong indicator of an acute myocardial infarction?

Accepted Answer

ST-segment elevation

Answer

ST-segment depression

Answer

T-wave inversion

Answer

Q waves

Question 14

In EKG interpretation, which finding is most indicative of an acute myocardial infarction?

Accepted Answer

ST-segment elevation in leads V1-V3

Answer

T-wave inversion in leads V5-V6

Answer

Q waves in leads II, III, and aVF

Question 15

In EKG interpretation, which finding is indicative of acute myocardial infarction, representing regions of dead heart muscle?

Accepted Answer

Q waves

Answer

ST-segment depression

Answer

T-wave inversion

Question 16

Which condition is the primary cause of myocardial infarction, accounting for most cases?

Accepted Answer

Atherosclerosis

Answer

Vasospasm

Answer

Hypertension

Answer

Congenital heart defects

Question 17

Which of the following is a less common cause of myocardial ischemia compared to atherosclerosis or vasospasm?

Accepted Answer

Microvascular disease

Answer

Pericarditis

Question 18

Which EKG finding definitively indicates a Q-wave myocardial infarction?

Accepted Answer

Pathological Q waves

Answer

ST-segment elevation

Answer

T-wave inversion

Question 19

For a patient experiencing ST-elevation myocardial infarction (STEMI), which initial treatment is most crucial?

Accepted Answer

Administer thrombolytic therapy to dissolve the obstructing clot

Answer

Provide nitroglycerin to reduce chest pain

Answer

Give aspirin to prevent additional blood clots

Question 20

Which EKG finding is NOT typically associated with myocardial infarction?

Accepted Answer

Normal sinus rhythm

Answer

ST-segment elevation

Answer

Q waves

Answer

T-wave inversions

Question 21

In the context of an acute myocardial infarction, which EKG finding is a strong indicator of the presence of Q waves?

Accepted Answer

Pathological Q waves in multiple leads

Answer

ST-segment elevation in multiple leads

Answer

T-wave inversions in multiple leads

Question 22

In EKG interpretation, what is a key feature of a Q-wave myocardial infarction?

Accepted Answer

Q-wave formation

Answer

ST-segment elevation

Answer

T-wave inversion

Answer

Absence of P-waves

Question 23

In acute myocardial infarction, which EKG feature is a reliable indicator of damaged heart tissue?

Accepted Answer

ST-segment elevation

Answer

Prolonged PR segment

Answer

T-wave flattening

Answer

Shortened QRS duration

Question 24

What is the primary pathophysiological mechanism underlying myocardial ischemia?

Accepted Answer

Sustained vasoconstriction of coronary arteries, limiting myocardial blood flow

Answer

Sustained vasodilation of coronary arteries, reducing myocardial oxygen supply

Answer

Decreased myocardial oxygen demand, causing metabolic waste accumulation

Answer

Increased myocardial oxygen demand, depleting energy stores

Question 25

Which of the following is NOT a risk factor for myocardial ischemia?

Accepted Answer

Regular exercise

Answer

Hypertension

Answer

Smoking

Answer

Diabetes

Question 26

What is the primary cause of sudden heart attacks (acute myocardial infarction)?

Accepted Answer

Atherosclerosis

Answer

High blood pressure

Answer

Diabetes

Question 27

In an EKG, which finding is most indicative of NSTEMI?

Accepted Answer

ST-segment depression in multiple leads

Answer

ST-segment elevation in multiple leads

Answer

T-wave inversions in leads V1-V3

Answer

Q waves in multiple leads

Question 28

Which of the following is NOT a risk factor for myocardial ischemia?

Accepted Answer

Regular exercise

Answer

Hypertension

Answer

Smoking

Answer

Obesity

Question 29

In an EKG, which finding is the most indicative of an acute ST-segment elevation myocardial infarction (STEMI)?

Accepted Answer

ST-segment elevation in multiple adjacent leads

Answer

T-wave inversion in leads I and aVL

Answer

Q waves in leads II, III, and aVF

Answer

PR interval prolongation

Question 30

What condition is most likely to result in irreversible harm to the heart muscle?

Accepted Answer

Sustained loss of blood flow to the heart without reperfusion

Answer

Temporary loss of blood flow to the heart (ischemia) followed by restored blood flow (reperfusion)

Question 31

What is the main cause of myocardial ischemia?

Accepted Answer

Atherosclerosis

Answer

Coronary artery spasm

Answer

Hypertrophic cardiomyopathy

Question 32

Which advanced imaging technique offers the most thorough evaluation of myocardial perfusion and viability in patients suspected of having myocardial ischemia or infarction?

Accepted Answer

Cardiac MRI

Answer

Echocardiography

Answer

Nuclear stress testing

Answer

CT angiography

Question 33

Which nursing interventions are crucial for monitoring and managing a patient with an acute myocardial infarction?

Accepted Answer

Monitor vital signs, administer oxygen, provide pain relief, insert an IV line

Answer

Restrict fluids, elevate legs, auscultate breath sounds, obtain EKG

Answer

Monitor blood glucose, weigh daily, encourage ambulation, provide disease education

Question 34

Define hibernating myocardium and explain its significance in predicting the outcome and guiding the treatment of patients with myocardial ischemia.

Accepted Answer

Hibernating myocardium is a reversible form of myocardial dysfunction caused by prolonged ischemia.

Answer

Hibernating myocardium is irreversible myocardial damage that cannot be restored.

Answer

Hibernating myocardium has no bearing on the prognosis or management of myocardial ischemia patients.

Question 35

Which of the following statements about lifestyle modifications and their impact on myocardial ischemia and infarction is true?

Accepted Answer

Lifestyle modifications, including smoking cessation and exercise, are effective in reducing the risk of myocardial ischemia and infarction.

Answer

Lifestyle modifications have no significant impact on the risk of ischemic events.

Answer

Smoking cessation alone is sufficient to eliminate the risk of myocardial ischemia and infarction.

Answer

Lifestyle modifications are effective in reducing the risk of myocardial ischemia but not infarction.

Question 36

Explain the development and consequences of chronic total occlusion (CTO) in coronary arteries on myocardial blood supply.

Accepted Answer

CTOs develop gradually, narrowing the coronary artery and reducing blood flow to the heart muscle.

Answer

CTOs occur abruptly, cutting off blood flow to a specific area of the heart muscle.

Answer

CTOs only affect small coronary arteries, leaving larger vessels unaffected and maintaining adequate blood flow to the heart muscle.

Answer

CTOs are reversible conditions that can improve with medication.

Question 37

How does nuclear cardiology testing, like myocardial perfusion imaging, contribute to patient care in managing myocardial ischemia and infarction?

Accepted Answer

Assessing myocardial blood flow and viability

Accepted Answer

Monitoring response to therapy

Answer

Detecting arrhythmias

Answer

Evaluating cardiac function

Question 38

Explain the pathophysiology of Prinzmetal angina, highlighting its distinction from other types of angina.

Accepted Answer

Prinzmetal angina is caused by vasospasm in the coronary arteries, leading to a temporary reduction in blood flow to the heart muscle.

Answer

Prinzmetal angina occurs due to atherosclerotic plaque rupture, obstructing coronary arteries.

Answer

Prinzmetal angina is characterized by persistent chest pain lasting over 30 minutes, accompanied by ST-segment depression.

Question 39

What is the clinical significance of ST-segment elevation greater than 1 mm in two or more contiguous EKG leads?

Accepted Answer

Confirms a myocardial infarction

Answer

Suggests ischemia or pericarditis

Answer

Is a common variant and requires no further action

Answer

Requires additional diagnostic testing

Question 40

Which of the following EKG findings is commonly associated with acute myocardial infarction?

Accepted Answer

Deeply inverted T-waves

Answer

Prominent and peaked T-waves

Answer

Substantially widened QRS complex

Answer

Absent P-waves

Question 41

Which specific artery occlusion is most often associated with anterior ST-segment elevation on an EKG?

Accepted Answer

Left anterior descending artery occlusion

Answer

Right coronary artery occlusion

Answer

Left circumflex artery occlusion

Answer

Pericardial inflammation

Question 42

What is the significance of reciprocal ST-segment changes on an EKG?

Accepted Answer

Indicates ischemia in an adjacent myocardial region

Answer

Is always associated with myocardial infarction

Answer

Is a normal variant and requires no further evaluation

Answer

Is an artifact that can be ignored

Question 43

Which of the following symptoms is NOT commonly associated with acute myocardial infarction?

Accepted Answer

Fever

Answer

Chest pain

Answer

Shortness of breath

Answer

Nausea and vomiting

Question 44

What is the preferred first-line treatment for ST-elevation myocardial infarction (STEMI)?

Accepted Answer

Percutaneous coronary intervention (PCI)

Answer

Aspirin and heparin

Answer

Nitroglycerin and morphine

Answer

Thrombolytic therapy

Question 45

What is the prognostic significance of LBBB in the context of acute myocardial infarction?

Accepted Answer

Increased mortality

Answer

Improved survival

Answer

No impact on prognosis

Answer

Predicts ventricular arrhythmias

Question 46

In the context of acute transmural myocardial infarction, which EKG change is characteristic?

Accepted Answer

ST-segment elevation

Answer

ST-segment depression

Answer

T-wave inversion

Answer

QRS complex widening

Question 47

Following an ST-segment elevation myocardial infarction, which T-wave change is common?

Accepted Answer

T-wave inversion

Answer

T-wave flattening

Answer

T-wave peaking

Answer

T-wave widening

Question 48

Which EKG finding suggests a non-Q-wave myocardial infarction?

Accepted Answer

Absence of Q-waves in the affected leads

Answer

ST-segment elevation in multiple leads

Answer

T-wave inversion in multiple leads

Answer

ST-segment depression in multiple leads

Question 49

What is the clinical significance of a hyperacute T-wave?

Accepted Answer

Predicts a poor prognosis

Answer

Indicates transmural ischemia

Answer

Is a sign of reperfusion

Answer

Is commonly seen in subendocardial ischemia

Question 50

Which of the following EKG changes is commonly associated with pericarditis?

Accepted Answer

Diffuse ST-segment elevation

Answer

PR-segment depression

Answer

T-wave inversions in all leads

Answer

Q-wave abnormalities

Question 51

What is the characteristic EKG finding in Prinzmetal's angina?

Accepted Answer

ST-segment elevation during chest pain

Answer

ST-segment depression during chest pain

Answer

T-wave inversion during chest pain

Answer

Q-wave abnormalities during chest pain

Question 52

What is the most common EKG finding associated with myocardial bridging?

Accepted Answer

ST-segment depression

Answer

ST-segment elevation

Answer

T-wave inversion

Answer

Q-wave abnormalities

Question 53

Which EKG change is a characteristic finding in acute myocardial ischemia?

Accepted Answer

ST-segment elevation ≥2 mm in at least two contiguous leads

Answer

ST-segment depression ≥1 mm in at least two contiguous leads

Answer

T-wave inversion ≥1 mm in at least one lead

Answer

PR interval prolongation

Question 54

A patient presents with chest pain and an EKG showing significant ST-segment depression. Which underlying condition is most likely?

Accepted Answer

Angina

Answer

Myocardial infarction

Answer

Pericarditis

Answer

Hyperkalemia

Question 55

A patient with a history of myocardial infarction has an EKG showing T-wave flattening. What is the most probable underlying cause?

Accepted Answer

Digitalis toxicity

Answer

Hypokalemia

Answer

Myocarditis

Answer

Asymptomatic ventricular tachycardia

Question 56

A patient presents with an EKG showing reciprocal ST-segment changes. What is the most likely explanation for this finding?

Accepted Answer

Myocardial ischemia

Answer

Acute myocardial infarction

Answer

Pericarditis

Answer

Left ventricular hypertrophy

Question 57

How can you distinguish unstable angina from stable angina based on its clinical presentation?

Accepted Answer

Unstable angina is associated with chest pain that is not relieved by nitroglycerin.

Answer

Unstable angina is less severe than stable angina.

Answer

Unstable angina only occurs during physical exertion.

Question 58

Microvascular angina is characterized by which of the following?

Accepted Answer

Chest pain resulting from impaired blood flow in small coronary arteries

Answer

Prolonged chest pain due to coronary artery spasm

Answer

Chest pain triggered by physical exertion or emotional stress

Question 59

In managing patients with acute myocardial infarction, which ethical principle is of utmost importance?

Accepted Answer

Respecting the patient's autonomy and right to make decisions about their own care

Answer

Prioritizing cost-effectiveness and resource allocation in treatment decisions

Answer

Allowing the provider's personal beliefs or preferences to influence treatment choices

Answer

Involving the patient's family in decision-making, even if their wishes conflict with the patient's

Question 60

How does stress testing aid in evaluating and managing myocardial ischemia?

Accepted Answer

Stress testing dynamically assesses myocardial perfusion during increased workload.

Answer

Stress testing confirms acute myocardial infarction.

Answer

Stress testing only detects severe myocardial ischemia.

Answer

Stress testing has no role in guiding treatment for myocardial ischemia.

Question 61

What is the most significant EKG finding in the early stages of an acute anterior myocardial infarction?

Accepted Answer

ST-segment elevation in leads V1-V4

Answer

ST-segment depression in leads II, III, and AVF

Answer

T-wave inversion in leads V5-V6

Answer

QRS complex widening in all leads

Question 62

Which lead provides the best view of the inferior wall of the heart for EKG interpretation?

Accepted Answer

Lead AVF

Answer

Lead I

Answer

Lead II

Answer

Lead III

Question 63

Which of the following is a characteristic EKG finding in STEMI (ST-Elevation Myocardial Infarction)?

Accepted Answer

Persistent ST-segment elevation of at least 1mm in two or more contiguous leads

Answer

ST-segment depression in leads V1-V3

Answer

T-wave inversion in leads II, III, and AVF

Answer

QRS complex fragmentation in all leads

Question 64

What is the clinical significance of a Q wave on an EKG?

Accepted Answer

Indicates a previous myocardial infarction

Answer

Suggests ongoing ischemia

Answer

Signifies ventricular hypertrophy

Answer

May indicate a bundle branch block