Acute Coronary Syndrome: Recognition and Response

By VeriScorePrep Team · 5 min

Acute coronary syndrome spans unstable angina and myocardial infarction. The presentation can be subtle, and time is muscle.

Presentation

Classic: crushing or pressure-like chest pain or discomfort, often radiating to the arm, jaw, neck, or back, with diaphoresis, nausea, dyspnea, or a sense of doom. Women, older adults, and people with diabetes more often present atypically — fatigue, dyspnea, epigastric discomfort — so maintain high suspicion.

Immediate actions

• Assess and support ABCs; attach monitor.
• Get a 12-lead ECG immediately (goal within 10 minutes of arrival).
• Administer oxygen only if hypoxic (routine high-flow oxygen is no longer standard).
• Nitroglycerin for chest pain if not contraindicated (check blood pressure first).
• Aspirin chewed (162–325 mg) per protocol.
• Morphine for refractory pain (hold if hypotensive).

Troponin

Cardiac-specific troponin rises within hours and remains elevated for days, making it the preferred biomarker.