Acute Coronary Syndrome (ACS): Overview & Symptoms

In today’s micro lecture, Australian Paramedical College Hon. Snr. Lecturer Sam Willis discusses acute coronary syndrome (ACS) which refers to one of three diseases caused by the heart: STEMI, non-STEMI, and unstable angina.

In today’s micro lecture we’re going to talk about acute coronary syndromes. Now ACSs, or acute coronary syndromes, really does refer to one of three diseases caused by the heart: STEMI, non-STEMI, and unstable angina. So when you hear the term ACS, or acute coronary syndromes, you’re only ever talking about those three things. You’re not talking about any other type of cardiomyopathy or disease of the heart, not heart failure, not LVF, nothing else just STEMI, non-STEMI, and unstable angina.

STEMI stands for ST segment elevation myocardial infarction. When you look at the ECG, the ST part of that segment of that ECG, there’s a particular part called an ST segment is elevated above the line, in other words, elevated about where it should be by two or more small squares. That’s called a STEMI. Now for it to truly be a STEMI, it has to be two or more small squares in two or more leads. That’s something you’ll learn a little bit more detail about in the clinical face-to-face workshops and online.

Now a non-STEMI is still a myocardial infarction, it’s still a heart attack, but there’s no elevation on the ECG. Instead, what you will see is things like depression, ST segment depression, T waves that are flipped, P waves that are inverted, but the patients are still presenting with the same signs and symptoms.

Then of course finally, unstable angina. Now the word unstable that it can come on at any point, any time, without any warning, which what makes it unstable. Now these patients require you to be calm, professional, and provide them a timely treatment because they really do say that in these patients that time is myocardium. Of course, myocardium is the heart muscle. So you need to be professional and calm. You need to assess them using the primary survey and the OPQRS and T pneumonic, the sample pneumonic. Then give them aspirin gt and a nitrates and pain relief in line with your pharmaceutical guidelines.

Now the typical signs and symptoms include impending doom. They will tell you they are dying and they feel like they are dying. They will have left-sided chest tightness radiating up to their jaw into their back, into their shoulder, shortness of breath, nausea and vomiting. But they also may have different variations of these. They won’t always have all of these all of the time. It’s your job to try and determine if this is an ACS or something else.

Once you’ve determined it’s an ACS and you’ve provided treatment, the best place for this person is in the cardiac cath lab. Rather than taking them to the emergency department, you really do need to take them to the best place.

So that’s the micro lecture on acute coronary syndromes.

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