I.

Introduction

Acute coronary syndrome is an umbrella term for situations where the

blood
supplied to the heart muscle is suddenly blocked. (AHA, 2015). Between 10% and 30%
of the client with unstable angina progress to having an MI in 1 year and 29% die of MI
in 5 years (AHA, 2003)
According to the latest WHO data published in 2017 Coronary Heart
Disease Deaths in Philippines reached 122,950 or 19.86% of total deaths. The age
adjusted Death Rate is 191.79 per 100,000 of population ranks Philippines #28 in the
world. Acute coronary syndrome is a condition of unstable cardiac ischemia. ACS
includes unstable angina and acute myocardial ischemia with or without significant
injury of the myocardial tissue. As estimated, 1.4 million Americans are admitted to the
hospital annually because of ACS (Kasper et. Al.., 2005).
The signs and symptoms of ACS are chest pain or discomfort in on or
both arms, jaw, neck, back or stomach; shortness of breath; dizziness; nausea;
diaphoresis (AHA, 2015). The AHA guidelines continue to emphasize the importance of
primary prevention of ACS by decreasing coronary artery disease risk factors such as
hypertension, hypercholesterolemia, diabetes mellitus, sedentary lifestyle, obesity,
smoking and family history. Initial care includes a full assessment of clinical symptoms,
risk factors, as well as 12-lead ECG and obtaining cardiac biomarkers. Anticoagulants,
antiplatelet, O2 therapy, nitroglycerin, morphine, beta-blockers, ACE inhibitors, and
statins are also ordered and given to manage ACS (Swiraj, MD, Christensen, MD.,
Brewer, 2017).
The areas of heart muscle that have poor blood flow but that have not died
can be very irritable. This irritability can cause heart rhythm problems, such
as ventricular tachycardia or ventricular fibrillation. These rhythm problems greatly
interfere with the heart’s pumping ability and may cause the heart to stop beating
(cardiac arrest). A loss of consciousness or death can result. These rhythm
disturbances are a particular problem in people who have an imbalance in blood
chemicals, such as a low potassium level. (Howlett, MD., 2016)