• PA
    PA School SurvivalDidactic Year
Subjects
  • 📖Medical Terminology
  • 🦴Gross Anatomy
    • Study Playbook
    • By Region
    • PNS Chart
    • My Lectures
    • Practice
  • 🧬Immunology & Genetics
    • Study Playbook
    • By Topic
    • My Lectures
    • Practice
  • 🧪Physiology
    • Study Playbook
    • By System
    • My Lectures
    • Practice
My material
  • 🗂️My Library
  • ✍️Notes & Sketches
Study Tools
  • 🎓Flashcards
  • 📡To revisit
  • 🗓️Calendar
  • 📈Progress
  • ✅Prep Rounds
  • 🧬Body Systems
  • 💊Pharmacology
  • 🔗Offsite Resources
  • 🧭Guide & FAQ
  • 💡
    Suggest a FeatureLet us know what we can do better — we genuinely want to help you in class.
PANCE Body Systems
  • 🫀Cardiovascular
    11%
  • 🫁Pulmonary
    9%
  • 🍎Gastrointestinal/Nutrition
    8%
  • 💪Musculoskeletal
    8%
  • 🧠Neurology
    7%
  • 🦠Infectious Disease
    7%
  • 💭Psychiatry/Behavioral
    7%
  • 🤰Reproductive
    7%
  • 🦋Endocrine
    6%
  • 👁️Eyes/Ears/Nose/Throat
    6%
  • 🩸Hematology
    5%
  • 🫘Renal
    5%
  • 💧Genitourinary
    4%
  • 🖐️Dermatology
    4%
Weights are study aids — verify each exam cycle.
⌘K
NotesPricingSign in
About·Tools·Terminology·Anatomy playbook·Anatomy by region·Immunology & genetics·Immunology playbook·Physiology·Physiology playbook·Privacy Policy·Terms of Service·PANCE Blueprint

PANCE® is a registered trademark of the National Commission on Certification of Physician Assistants (NCCPA). This application is an independent study resource and is not affiliated with, sponsored by, or endorsed by the NCCPA.

For educational use only. Content is AI-generated, may contain errors, and is not medical advice — always verify against current primary sources and faculty guidance before clinical use.

HomeCardiovascularAcute Coronary Syndrome (STEMI)
🫀

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 ≥1 mm in ≥2 contiguous leads (higher cutoffs in V2–V3) + troponin (hs-cTn preferred). Angiography defines the culprit lesion.
💊First-line Treatment
ASA + P2Y12, anticoagulation, beta-blocker, high-intensity statin; PCI <90 min (120 if transfer), else fibrinolytics. O₂ only if hypoxic.
Drug cardsAspirinClopidogrelHeparin (Unfractionated)AtorvastatinNitroglycerin
High-Yield Pearl

Time is muscle — door-to-balloon (FMC-to-device) <90 min, 120 if transferred. Do NOT give nitrates if RV infarct or recent PDE-5 inhibitor.

Sources

Reviewed September 2026
  1. 2025 ACC/AHA/ACEP/NAEMSP/SCAI Guideline for the Management of Patients With Acute Coronary Syndromes — ACC/AHA/ACEP/NAEMSP/SCAI, 2025
  2. StatPearls: Acute ST-Segment Elevation Myocardial Infarction (STEMI) — NCBI Bookshelf / StatPearls, 2025
  3. StatPearls: Acute Coronary Syndrome — NCBI Bookshelf / StatPearls, 2025

Checked against the guideline or standard reference the exam keys to. If it has moved, use Report an error below.

More Cardiovascular conditions

  • Acute Pericarditis
  • Aortic Dissection
  • Aortic Stenosis
  • Atrial Fibrillation
  • Deep Vein Thrombosis
  • Heart Failure (HFrEF)
  • Hyperlipidemia
  • Hypertension (Essential)
  • Hypertrophic Cardiomyopathy
  • Infective Endocarditis
  • Mitral Regurgitation
  • Peripheral Arterial Disease
All Cardiovascular