12 Lead EKG Chapter 4 Worksheet

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Dorthy Skinner
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1 Match the following using the word bank. 1. A form of arteriosclerosis in which the thickening and hardening of the vessels walls are caused by an accumulation of fatty deposits in the innermost lining of large and middle-sized muscular arteries. 2. ST elevation myocardial infarction 3. The result of intense spasms of a segment of an epicardial coronary artery. 4. A decreased supply of oxygenated blood to a body part or organ. 5. Acute coronary syndrome 6. A chronic disease of the arterial system characterized by abnormal thickening and hardening of the vessel walls 7. Symbol of chest pain; clinched fist held against the syndrome 8. Blood flow to the heart muscle stops or is suddenly decreased long enough to cause cell death 9. Ischemia, injury, or infarction that extends from the endocardium to the epicardium 10. The process of dissolving clots Word Bank A. ACS F. Levine s Sign B. Arteriosclerosis G. Myocardial Infarction C. Atherosclerosis H. Prinzmetal s Sign D. Fibrinolysis I. STEMI E. Ischemia J. Transmural

2 Select the best answer. 1. Acute coronary Syndrome (ACS) is the rupture of an atherosclerotic plaque 2. Non-modifiable risk factors of CAD are a. Smoking, obesity, and diabetes b. Heredity, gender, race and age c. Alcohol intake, hypertension, and stress 3. Stable (Classic) angina is a. Transient episodes of chest discomfort b. Pain that radiates into the lower extremities c. Constant pain that lasts for many hours 4. Unstable Angina is a. Very brief episodes of pain that lasts a few seconds or less b. Not associated with plaque rupture c. A syndrome of intermediate severity between stable angina and acute myocardial infarction 5. Acute MI duration is a. 7 to 28 days b. 29 days or more c. 6 hours to 7 days 6. The progress of tissue death has been described as a wave that begins in the endocardium and spreads to the epicardium.

3 7. A symptom that accompanies an acute MI are a. Shortness of air b. Anxiety c. Sweating d. All of the above 8. Mortality from acute MI decreases as the interval between symptom onset and initiation of treatment decreases. 9. Diabetes may present atypical symptoms with an acute MI. 10. In the acute phase of an NSTEMI, the ST segment may be elevated in the leads facing the surface of the infracted area 11. Confirmation of NSTEMI would be ST segment and T wave changes with a. Normal serum cardiac markers b. Elevation of serum cardiac markers 12. EKG changes indicating a myocardial infarction are a. P wave inversion and Q wave deepens b. ST segment depression c. T wave inversion and ST segment elevation 13. A Q wave that is one small box or more in width is suggestive of myocardial tissue death.

4 14. A definite acute coronary syndrome is a. Recent episode of typical ischemic discomfort b. An accelerating pattern of previous stable angina c. Stable angina that occurred at rest or within 2 weeks of a previously documented MI d. All of the above 15. Routine treatment measures for an AMI include the following EXCEPT a. Oxygen b. Diuretics c. Aspirin d. Nitroglycerin e. IV morphine 16. The goal for primary percutaneous transluminal coronary angioplasty (PTCA) is to achieve reperfusion and salvage of the myocardium 17. Other potentially lethal conditions that mimic AMI are a. Aortic dissection b. Acute pericarditis c. Acute myocarditis d. Pulmonary embolism e. All of the above 18. A 12-Lead EKG should be completed within 30 minutes of patient contact when presenting with a possible ACS 19. When analyzing a 12-Lead EKG of a possible ACS the patient is categorized into one of the 3 groups a. ST elevation, ST depression and non-diagnostic EKG b. ST depression, hyper acute T wave, and non-diagnostic EKG

5 c. ST depression, large Q wave and normal T wave 20. Bundle Branch Block, Left ventricular hypertrophy and paced rhythm may make EKG signs of ischemia or injury difficult or impossible to interpret

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