Introduction to cases

photo portrait of Hamish
Hamish is a 75-year old man from Aberdeen who is a retired fisherman and lives with his wife, Flora.
photo portrait of Joan
Joan is a 42-year old lawyer who is on holiday in the Highlands.
photo portrait of Naveed
Naveed is a 60-year old man who came to Scotland from Lahore 40 years ago and lives with his wife and has two grown up children.

Learning outcomes

This module explores the guidelines and information to the initial and ongoing care of an individual presenting with Acute Coronary Syndrome.

Learning outcomes:

  • Define the term Acute Coronary Syndrome
  • Describe the assessment and diagnostic process in ACS patients
  • Describe pharmacological management of ACS
  • Explain the rationale for diagnostic tests and different cardiac interventions in ACS
  • Understand secondary prevention of both pharmacological and non-pharmacological management following ACS

Acute Coronary Syndrome (ACS)

ACS is an umbrella term that covers a spectrum of clinical presentations. The common pathology is a ruptured plaque within a coronary artery leading to thrombosis and flow limitation. The exact clinical picture depends upon the site of plaque rupture and the extent of flow limitation.

Introduction

Introduction - Speech bubble

 

Module Authors

Module Lead

Steve McGlynn, Specialist Principle Pharmacist (Cardiology), NHS Greater Glasgow & Clyde

Module Authors

Dr Paul Neary, Consultant Cardiologist, NHS Borders
Margaret McGuire, NHS 24 Practice Educator, NHS 24
Gillian Donaldson, Lead Cardiac Specialist Nurse, NHS Borders
Joanna Toohey, Cardiology Nurse Specialist, NHS Dumfries & Galloway

Reviewers

Geraldine Brady, Lecturer/senior nurse, NHS Lothian
Avril Morrison, Specialist Chest Pain Nurse, NHS Lothian
Susan Kennedy, NHS Education for Scotland National Coordinator for General Practice Nursing
Louise Peardon, Deputy Director of Advice & Support, CHSS
Marie Hurson, Cardiac Nurse Specialist, NHS Shetland

Contributors

Anne McEwan, Team Leader Vascular Nurse, NHS Fife
Morag Osbourne, Psychologist,NHS Greater Glasgow & Clyde
Louise Peardon, Deputy Director of Advice & Support, CHSS
Carol Mills, Clinical Nurse Specialist, Cardiothoracic Surgery, NHS Lothian
Krista MacKellaig, Staff Nurse, NHS Lothian

4. Acute coronary syndrome

Learning outcomes

This module explores the guidelines and information to the initial and ongoing care of an individual presenting with Acute Coronary Syndrome.

Learning Outcomes:

  • Define the term Acute Coronary Syndrome.
  • Describe the assessment and diagnostic process in ACS patients.
  • Describe pharmacological management of ACS.
  • Explain the rationale for diagnostic tests and different cardiac interventions in ACS.
  • Understand secondary prevention of both pharmacological and non-pharmacological management following ACS.

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Key messages

Artherosclerosis (hardening of the arteries) affects all arterial beds throughout the body including the penile arteries which can cause problems with erectile dysfunction. However it should not automatically be presumed that it is being caused by CVD. An appointment with a GP where a full medical, social and sexual history as well as appropriate tests should be obtained

  • Non-adherence to prescribed medications has a enormous economic cost to the NHS as well as additional morbidity to patient. The health professional should routinely assess adherence whenever medication is prescribed, dispensed and reviewed
  • To have a basic knowledge of the major cardiovascular drugs that are used, common side-effects and contra-indications

A few weeks later

Ben has been back to the GP a couple of weeks later. The GP is much happier to learn that Ben is now taking his prescribed medication and continues to feel well.

The GP and Ben discuss his erectile dysfunction again and they both agree a trial of viagra will be suitable. The GP counsels Ben on how to use the drug appropriately and advise him to carefully read the manufacturers information leaflet. He advises Ben to return in a few weeks.

Ben's new results card from the doctor - see view text alternative for details