Cardiac Medicine Certification (CMC) Practice Exam

What medications are commonly used to lower cardiac workload and prevent reinfarction in patients with STEMI?

1. Aspirin and Plavix

2. Beta-blockers and ACE inhibitors

3. Nitrates and statins

4. Calcium channel blockers and anticoagulants

The correct answer is: Beta-blockers and ACE inhibitors

In patients with ST-Elevation Myocardial Infarction (STEMI), the management aims to lower cardiac workload and prevent reinfarction. Beta-blockers are commonly used in these cases due to their ability to reduce heart rate and myocardial oxygen demand, which alleviates stress on the heart. By blocking the effects of adrenaline and norepinephrine on the heart, beta-blockers help to diminish the risk of arrhythmias and subsequent cardiac events. ACE inhibitors play a crucial role as well, especially in patients with left ventricular dysfunction or heart failure. They help relax blood vessels, reducing preload and afterload on the heart, and consequently, they decrease myocardial oxygen demand. Furthermore, ACE inhibitors provide renal protection and have been shown to improve post-infarction outcomes, thereby further preventing reinfarction. In contrast, while other options may play important roles in the overall management of STEMI, they do not primarily focus on lowering cardiac workload in the same manner as beta-blockers and ACE inhibitors. Aspirin and Plavix primarily function to prevent platelet aggregation and thus reduce thrombus formation, while nitrates also help alleviate chest pain but are not the mainstay for long-term management in STEMI. Calcium channel blockers and anticoagulants have