Questions for Thelma McKenzie:

1.Should it be assumed that the learners know all of the terminology, or should a glossary be included for review?2.What information is still needed or should be increased? 3.What information is not necessary?

Please note that the design/layout is not a final, but merely a way to organize. The background, color, etc. is up for revision for the final design.

Acute Coronary Syndrome

Scene 1Acute Coronary Syndrome (ACS)

Unstable angina

Non-ST elevation myocardial infarction (NSTE – ACS)

ST elevation myocardial infarction (STE – ACS)

Scene 2

Scene 3

Elevated Cardiac Markers Troponin Creatinine Kinase – MB (CK-MB)

Scene 4

What do the symptoms of Acute Coronary Syndrome (ACS) include?

Pressure, squeezing, fullness or pain in center of chest that last for several minutes

Chest discomfort that spreads to jaw, neck, shoulders or arms

Chest discomfort that spreads into the back or between the shoulders

Scene 5

Other symptoms include:

Dizziness

Lightheadedness

Nausea

Sweating

Shortness of breath

Scene 6Scenario:

49-year-old woman

Diaphoretic

Short of breath

Tired

Nauseated

Skin pallor

Scene 7

FACTS:33% show no chest pain

40% of patients show Atypical chest pain

Diabetes

Hypertension

Heart failure

Prior stroke

Myocardial infarction (MI)

Scene 8

Scene 9

Review1. What is ACS?

2. What are the three (3) clinical syndromes of coronary artery disease?

3. What is the most common cause of ACS?

4. What are the most commom atypical locations and symptoms of chest pain?

1. an occlusion involving one or more of the coronary arteries

2. unstable angina, non-ST elevation myocardial infarction (NSTE – ACS), ST elevation myocardial infarction (STE – ACS)

3. rupture of lipid rich plaque

4. See scenes 8 & 9

Scene 10Acute Coronary Syndrome (ACS): In Women

Initial warning signs include:

Nausea

Fatigue

Dizziness

Shortness of breath

Scene 10a

Scene 11Acute Coronary Syndrome (ACS): In Women

Increased occurrence of radiating chest pain

right arm/shoulder

back of the neck

If hospitalized > 50 for MI – twice as likely to die in the hospital than men

Scene 12

Scene 13Acute Coronary Syndrome (ACS): In Women

According to the Journal of Pain and Symptom Management:

“…women are less likely to describe their discomfort as pain but rather describe it as “chest discomfort,” with associated shortness of breath, nausea, or loss of appetite.”

Scene 14Elderly, especially those > 75 exhibit other

symptoms:

Syncope

Confusion

Stroke

Fatigue

Note: 60% of MI patients are > 65

Scene 15

Scene 15a

Scene 15b

Scene 17

If ACS is suspected: Initial Treatments:

Oxygen Aspirin Nitroglycerin Morphine 12-lead EKG Reperfusion (if

indicated)