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Questions for Thelma McKenzie: Should it be assumed that the learners know all of the terminology, or should a glossary PowerPoint Presentation
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Questions for Thelma McKenzie: Should it be assumed that the learners know all of the terminology, or should a glossary be included for review? What information is still needed or should be increased? What information is not necessary?

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slide1

Questions for Thelma McKenzie:

Should it be assumed that the learners know all of the terminology, or should a glossary be included for review?

What information is still needed or should be increased?

What information is not necessary?

Please note that the design/layout is not a final, but merely a way to organize. The background, color, etc. is up for revision for the final design.

scene 1
Scene 1

Acute Coronary Syndrome (ACS)

  • Unstable angina
  • Non-ST elevation myocardial infarction (NSTE – ACS)
  • ST elevation myocardial infarction (STE – ACS)
scene 2
Scene 2
  • The rupture creates inflammatory response including:
                  • Platelet adhesion
                  • Platelet aggregation
                  • Thrombin formation
scene 3
Scene 3

Elevated Cardiac Markers

  • Troponin
  • Creatinine Kinase – MB (CK-MB)
scene 4
Scene 4

What do the symptoms of Acute Coronary Syndrome (ACS) include?

  • Pressure, squeezing, fullness or pain in center of chest that last for several minutes
  • Chest discomfort that spreads to jaw, neck, shoulders or arms
  • Chest discomfort that spreads into the back or between the shoulders
scene 5
Scene 5

Other symptoms include:

  • Dizziness
  • Lightheadedness
  • Nausea
  • Sweating
  • Shortness of breath
scene 6
Scene 6

Scenario:

  • 49-year-old woman
  • Diaphoretic
  • Short of breath
  • Tired
  • Nauseated
  • Skin pallor
scene 7
Scene 7

FACTS:

33% show no chest pain

40% of patients show Atypical chest pain

  • Diabetes
  • Hypertension
  • Heart failure
  • Prior stroke
  • Myocardial infarction (MI)
review
Review
  • What is ACS?
  • What are the three (3) clinical syndromes of coronary artery disease?
  • What is the most common cause of ACS?
  • What are the most commom atypical locations and symptoms of chest pain?
  • an occlusion involving one or more of the coronary arteries
  • unstable angina, non-ST elevation myocardial infarction (NSTE – ACS), ST elevation myocardial infarction (STE – ACS)
  • rupture of lipid rich plaque
  • See scenes 8 & 9
scene 10
Scene 10

Acute Coronary Syndrome (ACS): In Women

Initial warning signs include:

  • Nausea
  • Fatigue
  • Dizziness
  • Shortness of breath
scene 10a
Scene 10a

Acute Coronary Syndrome (ACS): In Women

As reported in the American Heart Journal:

“Women have significantly moreback pain, jaw pain, nausea, vomiting, dyspnea, indigestion, andpalpitationsthan men. “

scene 11
Scene 11

Acute Coronary Syndrome (ACS): In Women

  • Increased occurrence of radiating chest pain
    • right arm/shoulder
    • back of the neck
  • If hospitalized > 50 for MI – twice as likely to die in the hospital than men
scene 12
Scene 12

Acute Coronary Syndrome (ACS): In Women

As reported in the American Journal of Cardiology:

“…short-term mortality rate is

greater in women who have their first non-ST elevation myocardial infarction.”

scene 13
Scene 13

Acute Coronary Syndrome (ACS): In Women

According to the Journal of Pain and Symptom Management:

“…women are less likely to describe their discomfort as pain but rather describe it as “chest discomfort,” with associated shortness of breath, nausea, or loss of appetite.”

scene 14
Scene 14

Elderly, especially those > 75 exhibit other symptoms:

  • Syncope
  • Confusion
  • Stroke
  • Fatigue

Note: 60% of MI patients are > 65

scene 15
Scene 15

Acute Coronary Syndrome (ACS): In Elderly

According to the American Journal of Geriatric Cardiology:

“elderly patients lack anginal pain and have more palpitations, syncope, and dyspnea regardless of gender. Typically, chest pain presentation decreases with advanced age.”

scene 15a
Scene 15a

Acute Coronary Syndrome (ACS): In Elderly

According to the American Journal of Geriatric Cardiology:

  • 14% of elderly men less than or equal to age 65
  • 18% for those between 65 – 74
  • 30% for those 75-years and older
scene 15b
Scene 15b

Acute Coronary Syndrome (ACS): In Elderly

According to the American Journal of Geriatric Cardiology:

  • 19% of elderly women less than or equal to age 65
  • 28% for those between 65 – 74
  • 36% for those 75-years and older
scene 17
Scene 17

If ACS is suspected:

Initial Treatments:

  • Oxygen
  • Aspirin
  • Nitroglycerin
  • Morphine
  • 12-lead EKG
  • Reperfusion (if indicated)