Acute coronary syndrome: risk factors, diagnosis and treatment

It is estimated that in the UK there is an admission to hospital with a myocardial infarction every:

Modifiable risk factors for coronary heart disease and myocardial infarction include:

Use of cocaine may result in myocardial infarction, as cocaine may cause:

Typical symptoms of myocardial infarction include central crushing chest pain that may radiate to the left arm and/or jaw. However, some patients will not experience this pain and may have a ‘silent myocardial infarction’. This is more common in:

The electrocardiogram (ECG) is critical for diagnosis, but must be considered alongside patient history. If the ECG shows ST-segment elevation, the aim is to restore blood flow as soon as possible and the patient should be taken to:

A blood test for troponin is used in the diagnosis of myocardial infarction but may also be raised in other conditions including:

Following insertion of a drug-eluting stent into the artery, dual antiplatelet therapy is prescribed to reduce the incidence of:

Following hospital admission for a myocardial infarction, most patients will be prescribed (as a minimum) the combination of:

Following primary percutaneous coronary intervention for ST-segment elevation myocardial infarction, a patient is most likely to be prescribed the following doses of medication for the first year:

Eplerenone is recommended after myocardial infarction if the echocardiogram shows:

Dual antiplatelet therapy may increase the risk of gastrointestinal bleeding, particularly in high risk patients. A proton-pump inhibitor should be offered to:

A structured cardiac rehabilitation programme of exercise and education should be offered to all patients who have suffered a heart attack. This phase of cardiac rehabilitation typically runs over a period of:

After a myocardial infarction, angiotensin converting enzyme inhibitors are prescribed to reduce ventricular remodelling and preserve left ventricular function. The dose should be titrated to the target dose (or maximum tolerated). For ramipril the target dose is:

Following a myocardial infarction, a high-potency statin (one that will reduce low-density lipoprotein cholesterol by at least 40%) is recommended. Which of the following is not classified as a high-potency statin?

It is important that, if it is required, the patient knows how to use their glyceryl trinitrate spray. Which of the following are the correct instructions for the patient: