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# Acute Coronary Syndromes (ACS) - **Myocardial infarction:** Heart attack, Damage or death of an area of the heart muscle (myocardium) resulting from a blocked blood supply to that - **Coronary Thrombosis:** formation of a clot in one of the arteries that conduct blood to the heart muscle - **Coron...

# Acute Coronary Syndromes (ACS) - **Myocardial infarction:** Heart attack, Damage or death of an area of the heart muscle (myocardium) resulting from a blocked blood supply to that - **Coronary Thrombosis:** formation of a clot in one of the arteries that conduct blood to the heart muscle - **Coronary Occlusion:** obstruction of coronary artery that hinders blood flow to some part of the heart muscle - **Hypoxia:** decrease below normal levels of O2 in inspired gases, arterial blood, or tissue - **Ischemia:** local anemia d/t mechanical obstruction (mainly arterial narrowing), of the blood supply; often marked by pain and organ dysfxn ## Acute Coronary Syndrome - MC Sx - Describes pts w sudden imbalance bw myocardial oxygen consumption and demand - Usually acute ischemia and/or infarction d/t an abrupt reduction in coronary blood flow (obstruction) - Usually results from coronary plaque progression, instability w/wo luminal thrombosis - Eventual diagnosis determined by: symptomatic presentation - ECG changes - ST segment changes indicate injury, possibly necrosis, bc dead tissue cannot depolarize - T wave inversions indicate ischemia in absence of myocardial infarction - Detection of myocardial markers - Indication of myocardial necrosis - Stable Angina - Predictable anginal sx - **UA** - Ischemia but no permanent damage - (-) cardiac (+) ECG changes - Accelerating angina sx - **NSTEMI** - Ischemia d/t partial occlusion but no myocardial injury biomarker - (+) cardiac enzymes (+) ECG changes - Ischemia d/t partial occlusion + myocardial injury biomarkers - **STEMI** - (+) cardiac enzymes (+) ECG - Ischemia d/t complex occlusion + myocardial necrosis ## CP: - **Chest pain (angina)** - in @least 10 mins in duration - central/substernal compression or crushing chest pain - Pressure, tightness, heaviness, caramping, burning, aching sensation - Usually starts in retrosternal area and can radiate to one or both arms, neck, jaw - Usually accompanied by: severe dyspnea, diaphoresis, N/V, Syncope/presyncope ## Stable Vs. ACS Angina - **Stable angina** - predictable w activity, predictable in quality - **ACS angina** - accelerating symptoms