Acute coronary syndrome (ACS) is a collection of clinical presentations including unstable angina, non–ST-segment elevation myocardial infarction (NSTEMI), and ST-segment elevation myocardial infarction (STEMI). ACS is classically recognized by one or more of the following symptoms: crushing chest pain, shortness of breath, pain that radiates to the jaw, arm or shoulder, sweating, and/or nausea or vomiting. It is important to note that not all individuals with ACS will present with these classic findings, particularly women and patients with diabetes mellitus. It is impossible to determine a specific cardiac event from the ACS symptoms; therefore, ACS symptoms are managed in the same way.
Every patient with these symptoms should be evaluated immediately. If a patient appears to be unconscious, begin with the BLS Survey and follow the appropriate pathway for advanced care. If the patient is conscious, proceed with pathway below.