Acute Coronary Syndrome (STEMI)

Cardiovascular · ~11% of blueprint

Pathophysiology: Plaque rupture → thrombus → complete coronary occlusion → transmural ischemia/infarction.
Signs & Symptoms: Crushing substernal chest pain >20 min, radiates to L arm/jaw, diaphoresis, dyspnea, N/V.
Gold Standard Diagnosis: ECG (ST elevation ≥1mm in ≥2 contiguous leads) + troponin. Coronary angiography is definitive.
First-line Treatment: MONA-B + reperfusion: ASA + P2Y12, anticoagulation, statin; PCI <90 min (or fibrinolytics if PCI unavailable).

High-Yield Pearl

Time is muscle — door-to-balloon <90 min. Do NOT give nitrates if RV infarct or recent PDE-5 inhibitor.

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