Paramedic Recert EMS Care | 23-MCIT-F3-4110 | Acute Coronary Syndrome  starts with the introduction to the topic.

Cardiovascular Disease and its complications continue to be one of the most significant healthcare challenges in the United States. This chapter deals with the details of Acute Coronary Syndrome, its assessment and management

The lessons covered are

• Lesson 1: Acute Coronary Syndrome.
• Lesson 2: Evaluation And Management.
• Lesson 3: ECG.
• Lesson 4: Differential Diagnoses To ST Segment Elevations.  And,
• Lesson 5: Recent Advancements.

Excerpt Paramedic Recert EMS Care | 23-MCIT-F3-4110 | Acute Coronary Syndrome

While the physical examination in NSTE-ACS may appear normal, the presence of heart failure signs should prompt swift diagnosis and treatment.

Acute myocardial ischemia can give rise to indicators like an S4, paradoxical splitting of S2, or a new murmur stemming from mitral regurgitation due to papillary muscle dysfunction. However, these signs are not exclusive to NSTE-ACS and can occur in other contexts, making them nonspecific.

The combination of pain upon palpation, indicative of musculoskeletal disease or inflammation, with the identification of a pulsatile abdominal mass suggesting abdominal aortic aneurysm, should raise concerns about the nonischemic origins of NSTE-ACS.

Physical examination can unveil alternative diagnoses in chest pain patients, some of which pose life-threatening risks:

• Aortic dissection may be indicated by back pain, unequal palpated pulse volume, a systolic blood pressure difference exceeding ≥15 mmHg between both arms or a murmur of aortic regurgitation.
• The presence of a pericardial friction rub might suggest acute pericarditis.
• Cardiac tamponade can be reflected by pulsus paradoxus.
• If acute dyspnea, pleuritic chest pain, and differential breath sounds are present, suspicion for pneumothorax arises. And,
• A pleural friction rub may point towards pneumonitis or pleuritis.