No 2015 ACLS Guideline Changes For ACS Treatment.......Yet......

The AHA/ILCOR 2015 ACLS guidelines will be coming out by the end of this year(2015). So far, it appears most of the changes will be directed at the BLS level, with even more focus on high quality compressions, more efficient introduction of defibrillation through public access defibrillation programs, and more in-depth information on Return Of Spontaneous Circulation. Changes for AHA ACLS certification classes will probably be minimal.

The Meds for Acute Coronary Syndrome

It looks like ACLS meds for ACS treatment will not change:

• Oxygen
• Aspirin
• Nitroglycerin
• Morphine
• Fibrinolytic therapy
• Heparin
• Beta-Blockers

Acute Coronary Syndrome

What is acute coronary syndrome? 
Acute coronary syndrome is acute pain that results from a sudden decrease in the blood supply to the heart. The pain is so acute that it feels like the onset of a heart attack. In most cases, the patient feels as if the chest is being squeezed. In others the pain travels to the shoulders and arms and even the abdomen at times.


Causes of acute coronary syndrome
The cause of an acute coronary syndrome is not sudden. In fact, there is a slow and steady build up that can be detected in regular medical checkups. Plaque, made up of fatty deposits and calcium, accumulate in the coronary arteries over time. As the deposits increase the arteries narrow and the amount of blood that reaches the heart reduces. As the blockages increase there is a possibility of angina that results from reduced and inadequate blood that reaches the heart. When a piece of the plaque disengages or breaks off, clotting might create a complete blockage causing acute coronary syndrome.

Symptoms of acute coronary syndrome
Symptoms of acute coronary syndrome are similar to those of angina. However, they are generally more acute and severe in nature. A burning sensation in the chest and a tightening feeling that may occur immediately after exercise or consumption of a large meal are common symptoms. The pain may sometimes also occur in other parts of the body like the upper arm, shoulders or jaws. It is also not uncommon to experience nausea, vomiting, dyspnea or breathlessness, diaphoresis or excessive sweating and a feeling of lightheadedness.

Management of acute coronary syndromes 
Confirmation of acute coronary syndrome can be done by an ECG or Electrocardigram. This test records the electrical impulses of the heart with the use of electrodes. This is displayed on a monitor in the form of waves. Some blood tests can also detect a damaged heart due to the heart enzymes that leak into the blood stream. Other tests that are also done for further confirmation are Echocardiogram, chest x-ray, nuclear scan, Computerized tomography (CT) angiogram and Coronary angiogram (cardiac catheterization).

Immediate treatment includes blood thinners like aspirin and heparin to remove the blood clotting that is suspected. ACE inhibitors are used to reduce blood pressure and beta blockers are used to relax heart muscles. Surgical procedures become necessary when medicines are ineffective. Angioplasty is the most common surgical procedure that is recommended. It involves insertion of a wire with a deflated balloon into the tube. As the balloon is inflated, it squeezes the plaque against the arterial walls.

Acute coronary syndrome guidelines 

Prevention and management of acute coronary syndrome include various lifestyle management guidelines. Some of these are:

• Quitting smoking 
• Consuming a heart healthy diet that is low on saturated fat, red meat and salt and high on high fiber food like wheat, fruits, vegetables, fish and lean meat. Consider asking your primary care physician for a referral to a Registered Dietitian for this. 
• Regular cholesterol and blood pressure check-ups to ensure levels are under control
• Maintenance of health weight with regular exercise
• Taking significant steps to reduce stress levels
• Limiting consumption of alcohol