Acute Coronary Syndrome

(ACS)
Table of contents:
Definition of the ACS
Risk Factors

03 Clinical Manifestations

Classifications of ACS

Nursing Responsibilities
Introduction:

Remember :
*The most common cause of ACS is the
formation of a blood clot in artery
already narrowed
by an atherosclerotic plaque (Plaque is
made up of fat , fibrous tissue, calcium
and other substance that accumulate
slowly over time).

** A plaque may become inflamed and rupture

suddenly and a blood clot forms around it, cause
severely narrowing or blocking the artery.
Clinical Manifestations:
Shortness of breath.
Chest pain(pain may spread to back ,jaw, left
shoulder, arm).
Palpitations.
Epigastric pain.
Sweating.
Nausea & vomiting.
Tachycardia.
Risk Factors:
Aging
Hypertension (HTN).
diabetes.
High cholesterol level .
Smoking.
Lack of physical activity .
Unhealthy diet.
Family history.
Stress.
Classifications of ACS:
**Depending on the location and the extent of obstruction, one of the following conditions may result:

Unstable angina

Non-ST segment elevation myocardial

infarction (NSTEMI)

ST segment elevation myocardial infarction (STEMI)

**These conditions are differentiated

based on ECG and Cardiac marker
levels.
Definition: ischemia without
Unstable angina
infraction… when Heart not
getting enough blood flow
because of partial occlusion.
ECG: Normal
Troponin: Normal
Treatment: antiplatelet,
anticoagulant, lipid lowering
agent, CAG
 Non-ST-elevation myocardial
Definition: Heart not getting enough blood
infarction (NSTEMI)
flow due to partial occlusion , and that
causing injury and infract of
Myocardium tissue.
ECG: T wave inverted or ST depression.
Troponin: Elevated
Treatment: antiplatelet, anticoagulant,
lipid lowering agent, Beta-blockers.
Nitroglycerin, CAG.
 ST segment elevation myocardial
infarction (STEMI)
Definition: complete occlusion of
coronary arteries, and death of cardiac
tissue due to reduce of blood supply.
ECG: ST Elevation
Emergency
treatment (remember Troponin: Elevated
this word MONA)
MORPHINE Treatment: Thrombolytic thereby,
OXYGEN antiplatelet, anticoagulant, Beta-
NITROGLYCERIN
Aspirin blockers.
lipid lowering agent, PCI
Nursing Responsibilities:
Questions
Question 1:
Question 2:
Question 3:
References
1. Bhatt DL, Lopes RD, Harrington RA. Diagnosis and Treatment of Acute Coronary Syndromes: A
Review. JAMA. 2022 Feb 15:327 (7):662-675. Doi:10.1001/jama.2022.0358. Erratum in: JAMA.
2022 May 3:327 (17):1710.PMID: 35166796.

2. Javis S, Saman S (2017) Diagnosis, management and nursing care in acute coronary
syndrome. Nursing Times [online]; 113:3, 31-35.
Thank YOU
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