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    Acute Coronary Syndrome

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    SANU RAMASWAMY
    Acute coronary syndrome is usually caused by ST elevation myocardial infarction (STEMI), non-ST elevation myocardial infarction (NSTEMI), or unstable angina. It occurs when there is a partial or intermittent blockage of the coronary artery by a thrombus, restricting blood and oxygen flow to the heart. The main risk factors are heredity, age, gender, smoking, hypertension, high cholesterol, obesity, diabetes, physical inactivity, alcoholism, and oral contraceptive use. Symptoms include chest pain, dyspnea, nausea, and palpitations. Diagnosis involves electrocardiograms, cardiac enzyme tests, and coronary angiography. Treatment focuses on pain relief, reperfusion of the myocardium through procedures

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    Acute Coronary Syndrome

    Uploaded by

    SANU RAMASWAMY
    322 views24 pages
    Acute coronary syndrome is usually caused by ST elevation myocardial infarction (STEMI), non-ST elevation myocardial infarction (NSTEMI), or unstable angina. It occurs when there is a partial or intermittent blockage of the coronary artery by a thrombus, restricting blood and oxygen flow to the heart. The main risk factors are heredity, age, gender, smoking, hypertension, high cholesterol, obesity, diabetes, physical inactivity, alcoholism, and oral contraceptive use. Symptoms include chest pain, dyspnea, nausea, and palpitations. Diagnosis involves electrocardiograms, cardiac enzyme tests, and coronary angiography. Treatment focuses on pain relief, reperfusion of the myocardium through procedures

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    heart disease,acute coronary syndrome,myocardial infraction

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    Acute coronary syndrome is usually caused by ST elevation myocardial infarction (STEMI), non-ST elevation myocardial infarction (NSTEMI), or unstable angina. It occurs when there is a partial or intermittent blockage of the coronary artery by a thrombus, restricting blood and oxygen flow to the heart. The main risk factors are heredity, age, gender, smoking, hypertension, high cholesterol, obesity, diabetes, physical inactivity, alcoholism, and oral contraceptive use. Symptoms include chest pain, dyspnea, nausea, and palpitations. Diagnosis involves electrocardiograms, cardiac enzyme tests, and coronary angiography. Treatment focuses on pain relief, reperfusion of the myocardium through procedures

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    322 views24 pages

    Acute Coronary Syndrome

    Uploaded by

    SANU RAMASWAMY
    Acute coronary syndrome is usually caused by ST elevation myocardial infarction (STEMI), non-ST elevation myocardial infarction (NSTEMI), or unstable angina. It occurs when there is a partial or intermittent blockage of the coronary artery by a thrombus, restricting blood and oxygen flow to the heart. The main risk factors are heredity, age, gender, smoking, hypertension, high cholesterol, obesity, diabetes, physical inactivity, alcoholism, and oral contraceptive use. Symptoms include chest pain, dyspnea, nausea, and palpitations. Diagnosis involves electrocardiograms, cardiac enzyme tests, and coronary angiography. Treatment focuses on pain relief, reperfusion of the myocardium through procedures

    Copyright:

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    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 24

    SANU R 1ST YEAR MSC NURSING KIMS COLLEGE OF NURSING

    ACUTE CORONARY SYNDROME

    ACUTE CORONARY SYNDROME

    Acute coronary syndrome usually occurs as a result of one on three problems, STEMIand NSTEMI,unstable angina, and elevated serum cardiac markers .

    MYOCARDIAL INFRACTION
    AMI is also know as heart attack, coronary occlusion, or simply a coronary, characterized by the formation of localized necrotic areas with in the myocardium. The sudden occlusion of a coronary artery and abrupt cessation of blood and oxygen flow to the heart.

    UNSTABLE ANGINA
    Unstable angina is a paroxysmal chest pain triggered by predictable degree of exertion or emotion ,which may occur at night. It attacks characteristically increase in number, duration, and severity over time.

    ETIOLOGY

    Thrombus partially or intermittently occludes the coronary artery.

    NON MODIFICABLE RISK FACTORS


    Hereditary/ Family history Increasing age Gender

    MODIFICABLE RISK FACTORS


    Smoking Hypertension Elevated serum cholesterol levels Obesity Diabetes mellitus Physical inactivity Alcoholism Oral contraceptive pills Response to stress Inflammatory responses

    ANATOMY AND PHYSIOLOGY

    BLOOD SUPPLY OF THE HEART

    NERVE SUPPLY OF THE HEART

    CONDUCTION SYSTEM OF THE HEART

    Change in condition of the plaque in the coronary artery Activation of platelet

    PATHOPHYSIOLOGY

    Formation of thrombus

    ischemia
    Coronary blood supply less than demand Myocardial cell death Decreased contractibility

    Altered depolarization of myocardium Release of lysosomal enzyme Anaerobic glycosis Myocardial irritability

    ST Elevation Elevated CPKMB,TROPONI N I&T Lactic acid production dysrhythmias angina

    Decreased irritability
    Stimulation of sympathetic nervous system

    Decreased left ventricular function

    Increased heart rate Increased O2 needs Increased after load

    Increased preload

    Decreased cardiac output

    Increased CVP&PC WP

    Decreased LV function

    vasoconstriction

    CLINICAL MANIFESTATIONS

    Chest pain Dyspnoea Diaphoresis Nausea and vomiting Palpitations Fatigue and lethargy Syncope Anxiety Abdominal pain fever

    DIAGNOSTIC MEASURES
    History collection Electrocardiogram findings Laboratory test (serum cardiac makers) CK MB Myoglobin Troponin LDH Leukocytosis Coronary angiography

    CONT
    Position emission tomography Magnetic resonance imaging Echocardiography Tran esophageal echocardiography Chest x-ray

    ECG CHANGES

    COMPLICATIONS
    Dysrhythmias Heart

    failure Cardiogenic shock Pulmonary embolism Pericarditis Recurrent myocardial infarction Ventricular aneurysm Papillary muscle dysfunction Dressler syndrome

    MEDICAL MANAGEMENT
    Goals of medical management Initiating prompt care Reducing pain Delivering successful treatment for the accute pain and reperfusion of the myocardium Preventing complications Rehabilitating and educating the client and significant others

    EMERGENT PCI

    It is recommended as the first line of treatment for patients with confirmed MI

    DRUG THERAPY
    IV nitroglycerin Morphine sulphate adrenergic blockers Angiotensin converting enzyme inhibitors Antidysrhythmic Drugs Cholesterol- lowering drugs Stool softners Nutritional therapy

    INVASIVE CORONARY ARTERY PROCEDURES

    Percutaneous transluminal coronary angioplasty(PTCA) Directional coronary atherectomy (DCA) Intracoronary stents Laser ablation Trans myocardial revascularization

    PTCA

    Thank you.

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