Symptoms And Treatment Of Acute Coronary Syndrome

1231 Words Oct 31st, 2015 5 Pages
Acute Coronary Syndrome
Megan Kehn
Nursing 250
Delta College Disease Process Research has demonstrated that thrombus formation from an abrupt rupture of atherosclerotic plaque, which equates to diminished or complete termination of blood flow through the coronary artery, is the most common cause of an acute coronary event (EBP guidelines). The symptoms from the events are referred to as acute coronary syndrome, or ACS, and encompass the range of myocardial ischemic states that includes unstable angina (UA), non-ST elevated myocardial infarction (NSTEMI) and ST-segment elevation myocardial infarction (STEMI) (Lewis, 2011). The endothelial layer of the arteries are damaged over time by many disease processes that contribute to the
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When the foam cells accumulate in considerable amounts they create a lesion called a fatty streak in the arteries. After the streaks have been formed they continue to produce more toxic oxygen radicals, recruit T cells that lead to autoimmunity and emit additional inflammatory mediators that result in progressive damage to the vessel wall (Huether & McCance, 2012). In addition, the macrophages release growth factors that stimulate smooth muscle cell proliferation. In the region of endothelial damage, smooth muscle cells multiply, fabricate collagen and travel over the fatty streak, forming a fibrous plaque. The plaque may calcify, obtrude into the vessel lumen, and occlude blood flow to the distal tissue which may result in symptoms such as angina (Huether & McCance, 2012). However, many plaques are considered "unstable", implying that they are likely to rupture before they are large enough to decrease blood flow extensively enough to manifest symptoms, making them clinically silent until rupture. Once rupture occurs, the underlying tissue is exposed and platelet adhesion, the clotting cascade is begun and a thrombus is formed. If large enough, the thrombus may occlude the affected vessel, consequentially causing ischemia or infarction. The Journal of the American Board of Family Medicine contributes coronary heart disease as accountable for more than half of all the cardiovascular events in individuals younger than 75 years of age (Jennifer N. Smith,
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