Memory AnchorsNLE · Cardiovascular NursingReal content

NLE Cardiovascular Nursing — Coronary Artery Disease, Angina and Myocardial InfarctionMemory Anchors

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Memory anchors for Coronary Artery Disease, Angina and Myocardial Infarction — mnemonic devices, acronyms, and tricks that make the NLE Cardiovascular Nursing syllabus stick. Use these when a concept just will not stay in your head.

Exam context

On the NLE 2026, the Cardiovascular Nursing subtest carries a "Core" weight in Professional Regulation Commission (PRC) — Board of Nursing's pattern. Coronary Artery Disease, Angina and Myocardial Infarction lands at position 2nd out of 4 in the standard review order. Target score is 75% weighted average with no sub-test below 60%, and roughly 50 items come from Cardiovascular Nursing on a typical NLE paper.

Coronary Artery Disease, Angina and Myocardial Infarction - Memory Anchors

Memory techniques — mnemonics, analogies, micro-stories, and visual associations — can increase long-term retention by up to 40% compared to passive re-reading. For the NLE, where you must rapidly recall drug contraindications, diagnostic criteria, and management sequences under exam pressure, strong memory anchors are your secret weapon. Think of each anchor as a mental 'hook' — when you encounter a question about nitroglycerin contraindications or troponin levels, your brain automatically retrieves the vivid image, story, or acronym you attached to it. The goal of this section is to make every key concept in CAD, Angina, and MI permanently unforgettable by linking clinical facts to emotions, stories, humor, and familiar Filipino experiences. Master these anchors, and you will never blank out on cardiovascular nursing questions again.

Anchors

Topic

ACS Management - MONA

Concept

MONA framework and its modern nuances (Morphine, Oxygen, Nitroglycerin, Aspirin)

Anchor Id

Difficulty

medium

Memory Aid

Remember MONA as your 'patient's girlfriend' — but she has rules: ASPIRIN goes FIRST (she insists on respect), then NITRO (she calms things down), then OXYGEN only if she's suffocating (SpO2 below 90-94%), and MORPHINE is the LAST resort (only when nothing else works, because she tends to mask problems). So the modern sequence is really A-N-O-M: 'ANOM na MONA!' (Filipino for 'What is MONA?'). Priority drug = Aspirin. Last resort = Morphine. Oxygen = only if hypoxic.

Anchor Type

acronym

Why It Works

The classic MONA is familiar but misleading on sequence. By reimagining MONA as a person with rules and adding the Filipino phrase 'Anom na MONA,' students attach emotional context and cultural humor that makes the nuance stick.

Example Usage

Q: Which drug is the FIRST priority in ACS? Think 'MONA has rules — Aspirin goes first.' Answer: Chewable aspirin 160-325 mg.

Recall Trigger

Think 'Anom na MONA' every time you see ACS management questions.

Topic

Angina vs. MI Distinction

Concept

Difference between Angina and MI — reversible vs. irreversible

Anchor Id

Difficulty

easy

Memory Aid

Imagine your neighborhood's water supply (blood flow to the heart). ANGINA is like a temporary water interruption — 'brownout sa tubig' — the water stops for a while but comes back, and your pipes (heart muscle) are fine. MI is like a permanent pipe rupture — the pipe is destroyed and the area it supplies dies permanently. You can survive a brownout, but a busted pipe needs emergency repair RIGHT NOW. Reversible = Angina. Irreversible = MI.

Anchor Type

analogy

Why It Works

Filipino students are familiar with water interruptions (brownout sa tubig). Connecting a clinical concept to a lived everyday experience creates an emotional and sensory memory trace that is far more durable than rote memorization.

Example Usage

Q: A patient's chest pain resolves after rest. Cardiac markers are normal. This is most likely: Think 'brownout sa tubig' — temporary, reversible. Answer: Angina, not MI.

Recall Trigger

Think 'brownout sa tubig' — temporary interruption vs. permanent pipe rupture.

Topic

Diagnostics - Cardiac Biomarkers

Concept

Troponin and CK-MB are elevated in MI, not in angina

Anchor Id

Difficulty

easy

Memory Aid

Imagine a factory (the heart) that burns down (MI). When a factory burns, it releases SMOKE into the air — you can detect it miles away. Troponin and CK-MB are the 'smoke' of a burning heart. In angina, the factory just had a blackout — no fire, no smoke. So if you see elevated troponin or CK-MB, the factory has BURNED (necrosis = MI). Normal biomarkers = just a blackout = Angina.

Anchor Type

micro_story

Why It Works

The factory fire metaphor vividly links the concept of cellular necrosis (burning) to biomarker release (smoke), making the pathophysiology behind the diagnostic criterion unforgettable.

Example Usage

Q: A patient has crushing chest pain for 45 minutes. Troponin is elevated. What does this confirm? Think 'smoke from a burning factory.' Answer: Myocardial infarction (necrosis confirmed).

Recall Trigger

Elevated troponin = factory fire = MI. Normal troponin = blackout = Angina.

Topic

Nitroglycerin - Contraindications

Concept

Nitroglycerin contraindications — hypotension, inferior/RV MI, recent PDE5 inhibitor use

Anchor Id

Difficulty

hard

Memory Aid

Remember the mnemonic HIS for Nitro contraindications: H = Hypotension (systolic BP below 90 mmHg), I = Inferior MI / Right Ventricular MI (RV preload-dependent — nitro drops BP dangerously), S = Sildenafil/PDE5 inhibitors recently taken (profound hypotension risk). Say it as 'Nitro is not HIS to give' — if any of HIS conditions exist, withhold nitroglycerin!

Anchor Type

mnemonic

Why It Works

The short 3-letter acronym HIS is easy to recall and the phrase 'Nitro is not HIS to give' creates a possessive memory hook. Each letter anchors a critical safety fact, preventing a potentially life-threatening medication error.

Example Usage

Q: A patient with inferior MI has a BP of 88/60 mmHg. Should you give nitroglycerin? Run HIS: H = yes (hypotension), I = yes (inferior MI). Answer: CONTRAINDICATED — withhold nitroglycerin.

Recall Trigger

Before giving nitro, run through HIS: Hypotension? Inferior MI? Sildenafil?

Topic

Reperfusion Therapy - Time Targets

Concept

Door-to-balloon time (under 90 min for PCI) and door-to-needle time (under 30 min for thrombolytics)

Anchor Id

Difficulty

medium

Memory Aid

Chunk it as the 90-30 Rule using a basketball analogy: 'PCI is like shooting a 3-pointer — it's harder, takes more setup, but you get 90 seconds on the shot clock (90 minutes, door-to-balloon). Thrombolytics are a free throw — simpler, faster, 30 seconds on the clock (30 minutes, door-to-needle).' 90 = PCI balloon. 30 = thrombolytic needle. The harder shot gets more time.

Anchor Type

chunking

Why It Works

Filipino students are familiar with basketball (the Philippine national sport). Associating time targets with basketball shot clock creates a kinesthetic and sports-based memory that is culturally resonant and emotionally engaging.

Example Usage

Q: What is the target door-to-balloon time for PCI in STEMI? Think 'harder 3-pointer = 90 minutes.' Answer: Under 90 minutes.

Recall Trigger

Basketball: 3-pointer = 90 minutes PCI. Free throw = 30 minutes thrombolytics.

Topic

Thrombolytic Therapy - Contraindications

Concept

Thrombolytic absolute contraindications — bleeding risk

Anchor Id

Difficulty

hard

Memory Aid

Use the mnemonic BASH for absolute contraindications to thrombolytics: B = Bleeding actively (internal), A = Any hemorrhagic stroke (ever), S = Surgery/trauma recently (major, within 3 months also includes ischemic stroke within 3 months), H = Head lesion / intracranial neoplasm. Remember: 'Before you BASH the clot with thrombolytics, make sure the patient won't BASH their brain with bleeding!'

Anchor Type

mnemonic

Why It Works

BASH is a vivid, slightly aggressive word that matches the mechanism of thrombolytics — they aggressively dissolve clots. The word itself triggers the danger concept (bleeding), reinforcing the safety context naturally.

Example Usage

Q: A patient with STEMI had a hemorrhagic stroke 2 years ago. Can you give alteplase? Run BASH: A = any hemorrhagic stroke (absolute contraindication). Answer: NO — thrombolytics are absolutely contraindicated.

Recall Trigger

Thrombolytics = BASH the clot. But BASH = the contraindications too. Think bleeding!

Topic

Pathophysiology of CAD

Concept

Atherosclerosis pathophysiology — endothelial injury, LDL deposition, inflammation, fibrous plaque

Anchor Id

Difficulty

medium

Memory Aid

Imagine the coronary artery as EDSA (a major Manila highway). First, a pothole forms (endothelial injury). Trucks (LDL cholesterol) start parking in the pothole because of the damaged road. MMDA (inflammatory cells) arrive to investigate, but instead of fixing it, they make things worse and a concrete barrier (fibrous plaque) gets built over it. Soon, the lane narrows (stenosis). If the barrier cracks (plaque rupture), a traffic accident (thrombus) blocks the entire highway (coronary occlusion) — causing an MI.

Anchor Type

micro_story

Why It Works

EDSA is a universally recognized reference for Filipino students — everyone knows EDSA traffic. Mapping pathophysiology onto a familiar commuting experience makes the entire sequence concrete, spatial, and memorable.

Example Usage

Q: What is the mechanism of myocardial ischemia in CAD? Think EDSA: endothelial injury → LDL deposits → plaque forms → lumen narrows → ischemia. Answer: Atherosclerotic plaque narrows the coronary artery, reducing myocardial oxygen supply.

Recall Trigger

Think EDSA traffic: pothole → parked trucks → concrete barrier → total blockage = CAD pathway.

Topic

Types of Angina

Concept

Stable vs. Unstable Angina — triggers, relief, and implication

Anchor Id

Difficulty

easy

Memory Aid

Think of angina like a 'makulit na kapit-bahay' (annoying neighbor). STABLE angina is the neighbor who only knocks when you're noisy (exertion) — stop the noise (rest), give them a gift (nitroglycerin), and they leave. PREDICTABLE and MANAGEABLE. UNSTABLE angina is the neighbor who knocks at ANY TIME, even when you're sleeping, and does NOT leave even after gifts — this neighbor is dangerous (warning of impending MI) and needs HOSPITAL ADMISSION NOW. No rest or nitro will calm this one down.

Anchor Type

analogy

Why It Works

The 'makulit na kapit-bahay' is a deeply relatable Filipino neighborhood experience. Contrasting the 'predictable' vs. 'unpredictable' neighbor perfectly mirrors the clinical distinction between stable and unstable angina, anchoring both the trigger and the clinical urgency.

Example Usage

Q: A patient reports chest pain at rest, not relieved by nitroglycerin. How is this classified? Think 'unstable neighbor knocking at midnight.' Answer: Unstable angina — a form of ACS requiring immediate intervention.

Recall Trigger

Stable = predictable neighbor leaves with nitro. Unstable = knock at any time, won't leave = DANGER.

Topic

Types of Angina - Variant

Concept

Variant (Prinzmetal's) Angina — caused by coronary artery spasm, occurs at rest/at night

Anchor Id

Difficulty

medium

Memory Aid

Visualize a GARDEN HOSE (coronary artery) at night. Someone squeezes the hose tightly (vasospasm) while you are sleeping (at rest, nighttime). The hose doesn't have a blockage — it just crimps suddenly. Let go of the squeeze (spasm resolves) and blood flows again. This is Prinzmetal's — NO plaque needed, just a SQUEEZE at night. The image: a hand SQUEEZING a garden hose in the DARK (nighttime, at rest).

Anchor Type

visual_association

Why It Works

The visual of squeezing a garden hose is a concrete, kinesthetic image that perfectly represents vasospasm without plaque. The nighttime darkness emphasizes the 'at rest/nocturnal' timing. Visual associations are processed in multiple brain regions, increasing retention.

Example Usage

Q: Which type of angina is caused by coronary artery spasm and occurs at rest? Recall the garden hose squeezed in the dark. Answer: Variant (Prinzmetal's) angina.

Recall Trigger

Variant angina = garden hose being squeezed in the dark = vasospasm at rest/night.

Topic

Atypical MI Presentations

Concept

Atypical MI presentations in women, elderly, and diabetics

Anchor Id

A10

Difficulty

medium

Memory Aid

Story: Lola Coring (an elderly Filipina diabetic) comes to the ER saying she feels 'parang nasusuka lang' (just nauseous), 'pagod na pagod' (extremely fatigued), and 'nahihirapan huminga' (short of breath). No chest pain. The nurse almost sends her home — until a 12-lead ECG shows STEMI. Lola Coring had a SILENT MI — her diabetes caused neuropathy so she couldn't feel chest pain. REMEMBER: Women, elderly, and diabetics can have MI without classic chest pain — never dismiss their vague complaints.

Anchor Type

micro_story

Why It Works

Lola Coring is a culturally vivid and emotionally powerful character that Filipino students immediately identify with. The near-miss clinical scenario creates a moment of alarm that makes the lesson unforgettable. Narrative memory is one of the strongest forms of long-term retention.

Example Usage

Q: An elderly diabetic woman presents with fatigue, nausea, and shortness of breath without chest pain. What should the nurse prioritize? Recall Lola Coring. Answer: Obtain 12-lead ECG immediately — suspect atypical/silent MI.

Recall Trigger

Think Lola Coring: nausea + fatigue + dyspnea in elderly diabetic Filipina = possible silent MI.

Topic

Diagnostics - ECG Timing

Concept

12-lead ECG must be done within 10 minutes of presentation

Anchor Id

A11

Difficulty

easy

Memory Aid

Rhyme: 'Chest pain arrives, don't hesitate — ECG in TEN, it cannot wait! At the ten-minute gate, you must not be late — STEMI or not, you seal the patient's fate!' The number 10 is your trigger. First 10 minutes = ECG. This is non-negotiable in ACS triage.

Anchor Type

rhyme

Why It Works

Rhymes engage the phonological loop of working memory, making the specific time target (10 minutes) stick through rhythm and repetition. The urgency embedded in the rhyme also reinforces the clinical seriousness.

Example Usage

Q: A patient arrives in the ER with crushing chest pain. What is the priority nursing action and time frame? Recall the rhyme. Answer: Obtain a 12-lead ECG within 10 minutes of presentation.

Recall Trigger

Chest pain = ECG in TEN. Recite the rhyme mentally to recall the time target.

Topic

Complications of MI

Concept

Ventricular fibrillation is the leading cause of death in early MI

Anchor Id

A12

Difficulty

medium

Memory Aid

Visualize the heart as a DISCO BALL in a darkened room — it starts spinning chaotically with random flashing lights (VF = chaotic, uncoordinated electrical activity). The heart is no longer pumping blood — it's just quivering uselessly like a disco ball spinning out of control. The room (body) goes dark (cardiac arrest). This is why CONTINUOUS CARDIAC MONITORING is essential in the first hours of MI — to catch the disco ball before the room goes dark.

Anchor Type

visual_association

Why It Works

The disco ball is a vivid, absurd image for chaotic electrical activity that perfectly captures VF's erratic nature. The 'room goes dark' metaphor for cardiac arrest adds dramatic urgency. Absurd images are retained more easily than neutral ones.

Example Usage

Q: What is the leading cause of death in the early hours of MI, and what nursing intervention prevents it? Recall the disco ball. Answer: Ventricular fibrillation — continuous cardiac monitoring is essential for early detection and defibrillation.

Recall Trigger

VF = disco ball spinning out of control in the dark. Monitor the heart to stop the disco!

Topic

ACS Management - Aspirin

Concept

Aspirin must be CHEWED (not swallowed whole) for fastest absorption in ACS

Anchor Id

A13

Difficulty

easy

Memory Aid

Story: Nurse Ana is caring for a patient with chest pain. She gives aspirin 325 mg — but the patient swallows it whole like a vitamin. Nurse Ana gently reminds the patient: 'Nguya mo po, hindi basta lunukin' (Chew it, don't just swallow it). Why? Chewing breaks the tablet and speeds up absorption through the buccal mucosa and stomach — faster platelet inhibition, faster action, more lives saved. The chewing sound = faster aspirin absorption. 'Nguya = save a life.'

Anchor Type

micro_story

Why It Works

The Filipino instruction 'Nguya mo po' is instantly memorable and culturally natural. Linking the chewing action to a clinical outcome (faster absorption) gives the student a reason-why, which deepens encoding. It also models therapeutic communication.

Example Usage

Q: How should aspirin be administered in ACS? Recall 'Nguya mo po!' Answer: Chewable aspirin 160-325 mg — instructed to chew, not swallow whole, for rapid absorption.

Recall Trigger

Aspirin in ACS = 'Nguya mo po!' Chew it, don't swallow whole.

Topic

Patient Teaching - Nitroglycerin

Concept

Nitroglycerin storage — dark, airtight container; loses potency with heat and light

Anchor Id

A14

Difficulty

easy

Memory Aid

Nitroglycerin is like a shy, powerful 'bawal sa araw' (sun-sensitive) plant. It needs to be kept in a DARK, AIRTIGHT container — like a bulb hidden underground. Take it out into sunlight (heat and light exposure), and it loses its power quickly. Tell patients: 'Keep nitro in its original dark bottle, tightly closed, away from heat.' If the tablet doesn't fizz or tingle under the tongue, it has lost potency — replace it.

Anchor Type

analogy

Why It Works

The 'bawal sa araw' concept (sun-sensitive things) resonates with Filipino students who know certain things must be kept away from sun exposure. The sensory detail of a 'fizz or tingle' under the tongue as a potency test makes this clinically practical and memorable.

Example Usage

Q: A patient asks how to store nitroglycerin tablets. Recall the shy plant. Answer: Store in the original dark, airtight glass container at room temperature; keep away from heat, light, and moisture.

Recall Trigger

Nitro = shy bawal sa araw plant = dark, airtight bottle. No tingle = replace it.

Topic

CAD Risk Factors

Concept

Modifiable risk factors for CAD — the DOH PhilPEN targets

Anchor Id

A15

Difficulty

easy

Memory Aid

Use the mnemonic DISH OPS for modifiable CAD risk factors: D = Dyslipidemia (high LDL, low HDL), I = Inactivity (physical inactivity), S = Smoking, H = Hypertension, O = Obesity, P = Physical stress/psychosocial stress, S = Sugar (Diabetes Mellitus). 'DISH OPS' — as if serving a dish of problems that nurses must address in health teaching and DOH NCD screening (PhilPEN program).

Anchor Type

mnemonic

Why It Works

DISH OPS is easy to pronounce and the 'serving a dish' metaphor frames modifiable risk factors as things the nurse can 'remove from the menu' through health education — perfect for the nursing process and PhilPEN context.

Example Usage

Q: Which of the following is a modifiable risk factor for CAD? Think DISH OPS. Answer: Hypertension, dyslipidemia, smoking, obesity, diabetes, inactivity, stress — all are modifiable.

Recall Trigger

Modifiable CAD risks = DISH OPS. Remove this dish from your patient's lifestyle!

Topic

STEMI vs NSTEMI Management

Concept

STEMI vs NSTEMI — complete vs partial occlusion; thrombolytics ONLY for STEMI

Anchor Id

A16

Difficulty

hard

Memory Aid

Picture a water pipe (coronary artery). STEMI = pipe is COMPLETELY BLOCKED (total occlusion) — water (blood) stops entirely. NSTEMI = pipe is PARTIALLY CLOGGED — some water still trickles through. To dissolve a complete blockage, you pour in a powerful dissolving agent (thrombolytics = like Drano for arteries). BUT if the pipe is only partially clogged, you DON'T pour Drano — you use gentler methods (medical therapy, anticoagulants). Pouring Drano into a partially clogged pipe risks blowing it up (bleeding risk with no complete clot to dissolve).

Anchor Type

analogy

Why It Works

The household plumbing analogy is immediately concrete and logical. The 'don't pour Drano into a partial clog' reasoning explains WHY thrombolytics are not used in NSTEMI, giving students understanding (not just memorization) of the clinical guideline.

Example Usage

Q: A patient has NSTEMI. Should thrombolytics be given? Recall the partially clogged pipe — no Drano. Answer: No — thrombolytics are NOT indicated in NSTEMI. Medical therapy and risk-stratified PCI are used.

Recall Trigger

STEMI = completely blocked pipe = Drano (thrombolytics OK). NSTEMI = partial clog = no Drano.

Topic

Adjunct Pharmacology - Beta Blockers

Concept

Beta-blockers in MI — reduce HR, BP, and myocardial oxygen demand; hold if bradycardic/hypotensive

Anchor Id

A17

Difficulty

medium

Memory Aid

Visualize a BRAKE PEDAL on the heart. Beta-blockers ARE the brake pedal — they slow the heart rate, lower BP, and reduce how hard the heart works (myocardial oxygen demand). But you cannot press the BRAKE when the car is already barely moving (bradycardia) or has no fuel pressure (hypotension) — you'll stall the engine completely. So: HOLD beta-blockers if HR is already slow or BP is already low. Brake = beta-blocker. Stalled car = contraindication.

Anchor Type

visual_association

Why It Works

The brake pedal is a universally intuitive mechanical image. Filipino students who have learned to drive or observed driving immediately understand that applying brakes to a stalled car is dangerous. This makes the 'hold if bradycardic/hypotensive' rule logical and vivid.

Example Usage

Q: When should metoprolol be withheld in an MI patient? Recall the brake pedal on a stalling car. Answer: Hold if the patient has bradycardia or hypotension.

Recall Trigger

Beta-blocker = brake pedal on the heart. Don't brake a stalled car (bradycardia/hypotension).

Topic

Adjunct Pharmacology - Antiplatelets

Concept

Dual antiplatelet therapy (DAPT) — aspirin plus clopidogrel/ticagrelor/prasugrel

Anchor Id

A18

Difficulty

medium

Memory Aid

Remember DAPT as 'Double Attack Platelet Team' — Aspirin is the Captain (always first), and the co-player is one of the P2Y12 blockers: Clopidogrel, Ticagrelor, or Prasugrel. Use the acronym CTP to remember the three options: C = Clopidogrel, T = Ticagrelor, P = Prasugrel. 'Captain Aspirin leads team CTP in a double attack on platelets.' No platelet = no clot propagation = less MI damage.

Anchor Type

mnemonic

Why It Works

Team sports language (captain, co-player, double attack) is familiar to Filipino students, especially those who play or follow basketball or volleyball. Framing DAPT as a team with roles makes the drug combination logic intuitive.

Example Usage

Q: What is the antiplatelet regimen used in ACS management? Think Double Attack Platelet Team. Answer: Dual antiplatelet therapy — aspirin PLUS a P2Y12 inhibitor (clopidogrel, ticagrelor, or prasugrel).

Recall Trigger

DAPT = Double Attack Platelet Team. Captain Aspirin + team CTP (Clopidogrel/Ticagrelor/Prasugrel).

Topic

Adjunct Pharmacology - Statins

Concept

Statins — lower LDL and stabilize plaque; monitor for myopathy and liver enzymes

Anchor Id

A19

Difficulty

medium

Memory Aid

Think of statins (atorvastatin, rosuvastatin) as the STREET SWEEPER of the bloodstream. They sweep away LDL (trash) and stabilize the plaque (stop cracks in the road surface). But the street sweeper can accidentally damage the road surface if overused — monitoring for MUSCLE PAIN (rhabdomyolysis) is like checking for road damage, and LIVER ENZYMES are like checking the sweeper's engine health. Sweep LDL, but watch the machine and the road.

Anchor Type

analogy

Why It Works

The street sweeper analogy links drug mechanism (LDL lowering + plaque stabilization) to monitoring requirements (myopathy + liver enzymes) through a single coherent image. The dual monitoring task is embedded naturally in the story of 'machine health' and 'road damage.'

Example Usage

Q: What adverse effects should be monitored in a patient taking atorvastatin after MI? Recall the street sweeper. Answer: Monitor for muscle pain/weakness (rhabdomyolysis) and elevated liver enzymes.

Recall Trigger

Statins = street sweeper. Monitor the road (muscles) and the engine (liver enzymes).

Topic

Cardiac Rehabilitation

Concept

Cardiac rehabilitation phases — inpatient, early outpatient supervised, long-term maintenance

Anchor Id

A20

Difficulty

medium

Memory Aid

Remember cardiac rehab phases with the acronym IEM — 'I Exercise More': I = Inpatient (bedside recovery, gentle movement while still in hospital), E = Early outpatient (supervised exercise program after discharge, first weeks), M = Maintenance (long-term self-managed exercise and lifestyle program). 'After an MI, my goal is to I-E-M: I Exercise More — safely, progressively, forever.'

Anchor Type

mnemonic

Why It Works

The self-affirmation 'I Exercise More' is motivational and mirrors the actual goal of cardiac rehabilitation — increasing physical capacity progressively. The three-letter sequence IEM is simple and the phrase gives each letter a logical connection to the phase it represents.

Example Usage

Q: What are the phases of cardiac rehabilitation? Recall IEM: I Exercise More. Answer: Phase 1 (Inpatient), Phase 2 (Early supervised outpatient), Phase 3 (Long-term maintenance).

Recall Trigger

Cardiac rehab phases = IEM = 'I Exercise More.' Inpatient → Early outpatient → Maintenance.

Revision Game

Troponin (I or T)

Clue

I am the most specific and sensitive cardiac marker. When I rise, it means heart muscle cells have DIED — not just stressed, but actually dead. Who am I?

Memory Link

A3 — Troponin = smoke from a burning factory. No smoke = no fire (no necrosis = angina, not MI).

Nitroglycerin

Clue

I am a vasodilator that relieves chest pain, but I have three sworn enemies: low blood pressure, inferior heart attacks, and a little blue pill. Give me only when those three enemies are absent. Who am I?

Memory Link

A4 — 'Nitro is not HIS to give' — HIS = Hypotension, Inferior MI, Sildenafil.

Ventricular Fibrillation (VF)

Clue

I am the leading cause of death in the early hours of a heart attack. I make the heart look like a disco ball — spinning chaotically with no real pumping. What am I?

Memory Link

A12 — VF = disco ball heart. Continuous cardiac monitoring is your defense against me.

Variant (Prinzmetal's) Angina

Clue

I am a type of angina that attacks at night, when you are at rest, without any plaque involvement. Someone just squeezes my pipes. Who am I?

Memory Link

A9 — Garden hose squeezed in the dark = vasospasm at rest/night = Prinzmetal's.

Percutaneous Coronary Intervention (PCI)

Clue

In a STEMI, I am the preferred treatment — I open blocked arteries with a balloon and stent. My time target from hospital door to balloon inflation is under 90 minutes. What procedure am I?

Memory Link

A5 — PCI = basketball 3-pointer. Harder shot, 90 minutes on the clock. Door-to-balloon under 90 min.

Dual Antiplatelet Therapy (DAPT)

Clue

I am the aspirin's partner in fighting clots — together we form a DOUBLE ATTACK PLATELET TEAM. My team includes three options: Clopidogrel, Ticagrelor, and Prasugrel. What therapy am I?

Memory Link

A18 — Captain Aspirin leads team CTP. Double Attack Platelet Team = DAPT.

Silent MI / Atypical MI presentation in diabetics (due to diabetic neuropathy)

Clue

Lola Coring came to the ER with just nausea, fatigue, and shortness of breath — no chest pain. Her ECG revealed a STEMI. Why did she have no chest pain? What is this called?

Memory Link

A10 — Lola Coring: elderly diabetic Filipina with silent MI. Diabetic neuropathy blunts chest pain sensation.

Thrombolytics (Fibrinolytics) — e.g., alteplase, streptokinase, reteplase, tenecteplase

Clue

I am the Drano of the bloodstream — I dissolve blood clots in coronary arteries. My biggest risk is bleeding, including brain bleeds. I am used in STEMI only when PCI is unavailable. My time target is door-to-needle under 30 minutes. What class of drugs am I?

Memory Link

A16 — Thrombolytics = Drano for completely blocked pipes (STEMI only). BASH-H contraindications screen for bleeding risk.

Troponin I and T = proteins released from damaged cardiac myocytes into the bloodstream. Elevation = myocardial cell death (necrosis). Serial = drawn at least twice (on arrival and 3–6 hours later) to capture the rise-and-fall pattern diagnostic of MI.

Is PCI available within 90 minutes?
YES: Go to PCI (door-to-balloon under 90 min)
NO: Are thrombolytics contraindicated? (BASH-H)
NO contraindications: Give thrombolytics (door-to-needle under 30 min, within 6-12 hours)
Contraindicated: Emergency transfer to PCI-capable center

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NLE Cardiovascular Nursing — Coronary Artery Disease, Angina and Myocardial InfarctionMemory Anchors

Exam context

Coronary Artery Disease, Angina and Myocardial Infarction - Memory Anchors

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