ACUTE CORONARY SYNDROMES

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ACUTE CORONARY SYNDROMES
Patricia Zdan, RN, CCRN November 25, 2002
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Major Syndromes

• Unstable Angina
• Non-Q Wave MI
• Q Wave MI

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Pathophysiology

• Obstruction by atherosclerotic plaque
• Hemorrhage into a plaque
• Embolism caused by thrombi or atheromatous
  material
• Coronary spasm

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Ischemic Changes in Myocardial Tissue

• Zone of ischemia
• Zone of injury
• Zone of infarction

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Collateral Circulation
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Diagnosis

• Ischemic-type chest discomfort
• EKG changes
• Rise and fall in serum cardiac markers

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Clinical Presentation

• Classic symptoms
• Chest discomfort
• Radiation
• Associated symptoms

• Atypical symptoms
• Elderly
• Diabetics
• Women

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Pain

• Angina or infarction
• Focused pain history

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EKG Criteria
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EKG Criteria
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EKG Criteria
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Serum Biomarkers

• Myoglobin
• Creatine kinase (CK) and CK-MB
• Troponin complex

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Immediate Management

• Oxygen
• Nitroglycerin
• Analgesia
• Aspirin
• Beta-blockers

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Thrombolytic Therapy
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Thrombolytic Process
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Healthy Heart