Acute Coronary Syndrome Alberto Foschi, MD Cardiology Department Saint Francis Hospital

Acute Coronary Syndrome What does this mean? Acute “ All of the sudden” event Coronary Involves arteries of the heart Syndrome Symptoms and signs

What does this mean?

Acute

“ All of the sudden” event

Coronary

Involves arteries of the heart

Syndrome

Symptoms and signs

Agenda Risk factors Presentation Diagnosis Treatment Recovery

Risk factors

Presentation

Diagnosis

Treatment

Recovery

Risk Factors Controllable Diabetes Hypertension Obesity Smoking High cholesterol Metabolic syndrome Stressful events Uncontrollable Family history Age Genetic sex

Controllable

Diabetes

Hypertension

Obesity

Smoking

High cholesterol

Metabolic syndrome

Stressful events

Uncontrollable

Family history

Age

Genetic sex

Presentation Chest Pain Center of chest May radiate to arm or jaw

Chest Pain

Center of chest

May radiate to arm or jaw

Presentation Shortness of breath Heart doesn’t receive enough blood

Shortness of breath

Heart doesn’t receive enough blood

Presentation Palpitations Extra beats

Palpitations

Extra beats

Presentation Cold Sweat Perspiration

Cold Sweat

Perspiration

Presentation Faint Feeling

Faint Feeling

Presentation Nausea or vomiting

Nausea or vomiting

Diagnosis Call 911 for emergency attention Emergent electrocardiogram Transfer to Chest Pain Center for treatment and confirmation of diagnosis “ Time is muscle” Act quickly

Call 911 for emergency attention

Emergent electrocardiogram

Transfer to Chest Pain Center for treatment and confirmation of diagnosis

“ Time is muscle”

Act quickly

Treatment Drugs for symptom relief To treat pain To alleviate shortness of breath Immediate angiogram and angioplasty (if done in under 90 minutes of onset of symptoms) Reduces mortality significantly Rule of 10 to 1 Every 10 minutes saved decreases mortality by 1%

Drugs for symptom relief

To treat pain

To alleviate shortness of breath

Immediate angiogram and angioplasty (if done in under 90 minutes of onset of symptoms)

Reduces mortality significantly

Rule of 10 to 1

Every 10 minutes saved decreases mortality by 1%

Recovery Aggressive correction of all risk factors Cardiac rehabilitation program

Aggressive correction of all risk factors

Cardiac rehabilitation program

Actual Angiogram Angiogram shows complete blockage

Actual Angiogram This shows the expansion of the stent by the balloon

Actual Angiogram The final picture of the angiogram after the coronary stent placement.