ACUTE CORONARY SYNDROME Acute Coronary Syndrome



Acute Coronary Syndrome

Review Case Study

The case is related to an old man William who is 49; he is brought to emergency department of hospital because of severe chest pain. After the complete diagnosis it has been found that he is suffering from Acute Coronary Syndrome, and then he is admitted to coronary care.

Answer no. 1

Acute coronary syndromes is abbreviated as (ACS) The term acute coronary syndrome describes a spectrum of cardiovascular diseases, which of the Unstable Angina (UA) to the two major forms of heart attack, the non-ST elevation myocardial infarction (NSTEMI) and ST elevation myocardial infarction (STEMI) is the cause of the acute event, a critical reduction in blood flow through the formation of a local thrombus on the floor of a plaque rupture or plaque erosion. While the blood clot in the vessel STEMI generally completely closes, remains in unstable angina and NSTEMI when the blood flows (Heart Foundation of Australia, 2000).

Evidence based Guideline for the Management

According to National Heart Foundation of Australia, Chest discomfort for more than 10 minutes is the time to take a person to medical emergency center. Patients suffering from symptom of an ACS must look for assistance quickly and activate urgent situation medical service. Preferably, the way of transportation must be an ambulance. Although, if the ambulance is not available or it will take a longer time to reach to the place where patient is, alternatives should be considered according to the available resources. It is not advice and prohibited that patient drives car itself because there is a high risk to other people on the road. If the patient is in the ambulance there should be a warning given to the emergency care center for the patient who is about to arrive in the hospital (Coory, Walsh, 2005, 507-512). When the patient arrived in the hospital the most significant preliminary requirement is to get defibrillator to evade premature cardiac casualty consequential from reversible arrhythmias. Patient should be give aspirin early (i.e., by emergency department nurses or ambulance staff) except previously taken.

Oxygen must be provided, glyceryl trinitrate should also be given according to the need and intravenous morphine could also be required (Chew, Aroney, Sheerin, 2005, S1-S16). At least, medical services getting patient must be given caution of upcoming patients in whom there is a increased chances suspicion of the disease ACS, mainly (STEMI) ST segment elevation myocardial infarction or whose situation is unsteady. A 12-lead electrocardiogram must be in use en route and transmit to a medical assistance if appropriate (Alpert, Thygesen, Antman, 2000, 959-969). First-Aid treatment (include fibrinolysis in suitable case) must be facilitated where formal protocol is in place. The ECG must be used on time by a suitably experienced and qualified person. Patient present with an assumed ACS must go through instant electrocardiography. Additional investigation may be essential, but it should not interrupt the treatment.

References

Alpert JS, Thygesen K, Antman E, Bassand JP. (2000) Myocardial infarction redefined — a consensus document ...