Non-ST-Segment Elevation MI: The Daily PANCE Blueprint

Non-ST-Segment Elevation MI: The Daily PANCE Blueprint

Which of the following is NOT true about a non-ST elevation myocardial infarction?

A. Non-enteric-coated, chewable aspirin 325 mg should be given
B. Troponins are elevated
C. It happens due to a partially occluded epicardial coronary artery
D. Patients need a 12-lead EKG
E. You will always see ST depressions

Answer and topic summary

The answer is E. You will always see ST depressions

A non-ST elevation myocardial infarction (NSTEMI) is defined by the absence of persistent ST-elevation with elevated cardiac biomarkers (e.g., troponin I or T, CKMB, etc). It happens due to a partially occluded epicardial coronary artery (leading to subendocardial ischemia). NSTEMI typically presents as pressure-type chest pain.

Patients with a suspected NSTEMI should receive a 12-lead EKG within 10 minutes of arrival. ST depression, transient ST-elevation, and/or T-wave inversions may be seen on EKG, but they are NOT required for the diagnosis of NSTEMI. The most important medication to give is non-enteric-coated chewable aspirin 325 mg. Other meds include sublingual nitroglycerin, oxygen as needed, beta-blockers (assuming no C/I), high-intensity statin, ACE inhibitors (if CKD, DM, or EF < 40%), P2Y12 inhibitor (e.g., clopidogrel), anticoagulation, and possibly PCI with stenting or CABG.

View blueprint lesson

Smarty PANCE Content Blueprint Review:

Covered under ⇒ PANCE Blueprint CardiologyCoronary Heart DiseaseAcute myocardial infarctionNon-ST-Segment Elevation MI (NSTEMI)

Also covered as part of the Family Medicine EOR, Internal Medicine EOR, Emergency Medicine EOR topic list

Sign up for the ENTIRE Blueprint Daily Email Series (800 daily questions. . . and counting! 😀)

X