Thrombolysis patient OSCE

Cardiology
by Medical Educator Cardiology

Thrombolysis is a medical treatment that uses drugs to dissolve blood clots that have formed in blood vessels and can lead to serious medical conditions such as stroke, heart attack, and deep vein thrombosis. This procedure is performed to restore blood flow and prevent the damaging effects of blood clots.

Our MCQ test is a fun and interactive way to test your knowledge and expand your understanding of this important topic. Get ready to learn below.

Table of Contents

Question 1

A 63 year old Music teacher has a full thickness inferior myocardial infarction. The paramedics feel that it is “thrombolysable” based on their ECG tracing. What would you expect to see on the ECG?

  • ST elevation in II III AVF
  • ST elevation V1 V2 V3
  • ST elevation V4 V5 V6
  • T wave inversion only
  • ST depression only

ST elevation in II III AVF.

The following is true for the different territories for each vessel…

II III AVF = inferior MI
V1 V2 V3 =Anterior wall MI
V4 V5 V6 = Lateral Wall MI
ST elevation is classical for a myocardial infaction

Question 2

Continued from previous question.

In this patient (inferior MI), which coronary artery(s)/ arterial territory is most likely to be affected?

  • Left Main Stem
  • Left Anterior descending
  • Right coronary artery
  • Left Obtuse Marginal
  • Circumclex

Right coronary artery.

Remember coronary artery supply comes from arteries originating from the aorta.

Left main stem splits into LAD (anterior V1-3) and Circumflex Lateral (V4-6).

Right coronary artery supplies inferior territory (II III AVF).

Question 3

Continued from previous question.

The ECG actually shows an anterior myocardial injury. The medical student feels its a “thrombolysable” anterior MI. Which of the following changes would make the ECG “thrombolysable”?

  • ST elevation of 1mm in leads V1 and V3
  • ST elevation of 1mm in leads V1 and V2 only
  • ST elevation of 1mm In Leads V1 V2 and V3 with t wave inversion in all those leads
  • ST depression of 2mm in leads V1 and V2
  • None of the above ECG changes are “thrombolysable”

None of the above ECG changes are “thrombolysable”.

To fit the ECG criteria you need 2 consecutive leads with 2mm in the anterior/ lateral leads OR 1mm in 2 consecutive inferior leads (II III AVF) OR new Left bundle branch block.