[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-373094-105":59,"doc-detail-373094-en":131},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":124,"head_meta":126,"extra_data":128,"updated_unix":130},105,"en","acute-coronary-syndromes-chapter-4-learning-outcomes","Acute Coronary Syndromes - Chapter 4 - Learning outcomes","","Acute coronary syndromes (ACS) are presented as a disease spectrum including unstable angina, NSTEMI, and STEMI. The material explains how these syndromes arise from plaque fissuring, hemorrhage, smooth muscle contraction, and thrombus formation leading to partial or complete obstruction or distal embolism. It outlines key learning outcomes: understanding disease processes, differentiating ACS types, delivering immediate treatment, and managing patients after recovery. Angina features, ECG patterns, troponin behavior, and risk implications are discussed to support assessment and treatment decisions.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/acute-coronary-syndromes-chapter-4-learning-outcomes/373094/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/acute-coronary-syndromes-chapter-4-learning-outcomes/373094.png","ImageObject",300,407,{"name":92,"@type":93},"Stanley","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-27","2026-09-23",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",15,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"What are the three main acute coronary syndromes covered here?","Question",{"text":113,"@type":114},"The document lists unstable angina, non-ST-segment-elevation myocardial infarction (NSTEMI), and ST-segment-elevation myocardial infarction (STEMI). These form a spectrum of the same underlying disease process.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"How does plaque fissuring lead to acute coronary syndromes?",{"text":118,"@type":114},"Plaque fissuring initiates hemorrhage into the plaque, causing swelling and narrowing of the arterial lumen. Smooth muscle contraction further constricts the lumen, while thrombus formation on the plaque may partially or completely obstruct flow or cause distal embolism.",{"name":120,"@type":111,"acceptedAnswer":121},"What ECG and troponin findings help differentiate unstable angina risk?",{"text":122,"@type":114},"In unstable angina, the ECG may be normal, show acute myocardial ischemia (often ST-segment depression), or show nonspecific abnormalities such as T-wave inversion. Troponin release is absent and enzymes are usually normal, but a normal ECG and absent troponin do not exclude high risk; further risk assessment may be needed.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},373094,1790242972,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":140,"language":141,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":142,"faqs":143,"seo_title":144,"seo_description":67,"update_tm":145,"read_time":146},2336477405376,"https://ap-avatar.wpscdn.com/davatar_29158cc5080c5b710cf443261637dec0","Acute Coronary Syndromes CHAPTER 4  \nLearning outcomes  \n􀀄􀀉 􀀍􀀈 􀀆 􀀇􀀊􀀋􀀌􀀅􀀈 􀀆 􀀃  \n􀀁 The disease process which gives rise to acute coronary syndromes  \n􀀁 How to differentiate between the acute coronary syndromes  \n􀀁 The immediate treatment of acute coronary syndromes  \n􀀁 Management of patients after recovery from an acute coronary syndrome  \nIntroduction  \nWhilst rapid resuscitation offers the best chance of recovery from cardiac arrest , it is clearly better to prevent cardiac arrest whenever possible. Many cardiac arrests are caused by underlying coronary artery disease and occur in the context of an acute coronary syndrome (ACS) . It is therefore important that the ALS provider understandshow to recognise an ACS , how to assess a patient with an ACS , and what treatments may reduce the risk of cardiac arrest and death.  \nDefinitions and pathogenesis  \nThe acute coronary syndromes (ACS) comprise:  \n• Unstable angina  \n• Non-ST-segment-elevation myocardial infarction  \n• ST-segment-elevation myocardial infarction  \nThese clinical syndromes form parts of a spectrum of the same disease process. In the vast majority of cases this process is initiated by the fissuring of an atheromatous plaque in a coronary artery causing:  \n• haemorrhage into the plaque causing it to swell and restrict the lumen of the artery;  \n• contraction of smooth muscle within the artery wall , causing further constriction of the lumen;  \n• thrombus formation on the surface of the plaque , which may cause partial or complete obstruction of the lumen of the artery, or distal embolism.  \nThe extent to which these events reduce the flow of blood  \nto the myocardium largely determines the nature of the clinical ACS that ensues.  \nAngina (stable and unstable)  \nAngina is pain or discomfort caused by myocardial ischaemia and is felt usually in or across the centre of the chest as tightness or an indigestion-like ache. As with acute myocardial infarction (AMI) , the pain/discomfort often radiates into the throat , into one or both arms , and into the back or into the epigastrium. Some patients experience angina predominantly in one or more of these areas rather than in the chest. Many patients perceive itas discomfort rather than pain. As with AMI , angina is sometimes accompanied by belching and this may be misinterpreted as evidence of indigestion as the cause of the discomfort. Pain of this nature , which is provoked only by exercise and which settles promptly when exercise ceases , is referred to as stable angina and is not an ACS.  \nIn contrast , unstable angina is defined by one or more of:  \n1. Angina on exertion , occurring over a few days with increasing frequency, provoked by progressively less exertion. This is referred to as ‘crescendo angina’.  \n2. Episodes of angina occurring recurrently and unpredictably, without specific provocation by exercise. These episodes may be relatively short-lived (e. g. a few minutes) and may settle spontaneously orbe relieved temporarily by sublingual glyceryl trinitrate , before recurring within a few hours.  \n3. An unprovoked and prolonged episode of chest pain , raising suspicion of AMI , but without definite ECG or laboratory evidence of AMI (see below) .  \nIn unstable angina , the ECG may:  \na) be normal ;  \nb) show evidence of acute myocardial ischaemia (usually ST segment depression) ;  \nc) show non-specific abnormalities (e. g. T wave inversion) .  \nIn unstable angina , cardiac enzymes are usually normal (but remember that there are causes other than myocardial infarction for elevated muscle enzymes such as creatine kinase [CK]) , and troponin release is absent. ECG abnormality, especially ST segment depression , is a marker of increased risk of further coronary events inpatients with unstable angina. However, a normal ECG  \nADVANCED LIFE SUPPORT  \nand absent troponin release does not necessarily mean that a patient with unstable angina is not at high risk of early further life-threatening coronary events. Only if th","cbCaiqXw0cbJ92MJ","https://ap.wps.com/l/cbCaiqXw0cbJ92MJ","pdf",1010964,14,"English","# Learning outcomes\n# Introduction\n# Definitions and pathogenesis\n## Angina (stable and unstable)\n## Non-ST-segment-elevation myocardial infarction (NSTEMI)","[{\"question\":\"What are the three main acute coronary syndromes covered here?\",\"answer\":\"The document lists unstable angina, non-ST-segment-elevation myocardial infarction (NSTEMI), and ST-segment-elevation myocardial infarction (STEMI). These form a spectrum of the same underlying disease process.\"},{\"question\":\"How does plaque fissuring lead to acute coronary syndromes?\",\"answer\":\"Plaque fissuring initiates hemorrhage into the plaque, causing swelling and narrowing of the arterial lumen. Smooth muscle contraction further constricts the lumen, while thrombus formation on the plaque may partially or completely obstruct flow or cause distal embolism.\"},{\"question\":\"What ECG and troponin findings help differentiate unstable angina risk?\",\"answer\":\"In unstable angina, the ECG may be normal, show acute myocardial ischemia (often ST-segment depression), or show nonspecific abnormalities such as T-wave inversion. Troponin release is absent and enzymes are usually normal, but a normal ECG and absent troponin do not exclude high risk; further risk assessment may be needed.\"}]","Acute Coronary Syndromes - Chapter 4 - Learning outcomes | PDF",1790196748,35]