Acute Coronary Syndrome: An Overview for Nurses

Course #30993 - $90 -


Although physicians are responsible for directing and prescribing care for patients with acute coronary syndrome (ACS), nurses play a vital role in promoting adherence to practice guidelines. This course begins with an overview of the scope of the problem and its economic impact on health care in the United States. An overview of the pathophysiology of ACS and its underlying disease process, coronary artery disease (CAD), will be presented to provide background for understanding specific practice recommendations. Clinical signs and symptoms, diagnosis, and management of UA, NSTEMI, and STEMI will be discussed and illustrated through the use of simulated clinical scenarios. Emergent assessment, diagnostic measures, and initial treatment options will be explored, followed by a discussion of follow-up care and preparation for discharge. Key points of secondary prevention, including smoking cessation, treatment of dyslipidemia, and modification of other risk factors will be outlined.

Education Category: Medical / Surgical
Release Date: 02/01/2022
Expiration Date: 01/31/2025

Table of Contents


This course is designed for nurses practicing in primary care, inpatient, outpatient, and home care settings to enhance their knowledge of the evidence-based guidelines related to the assessment, management, and secondary prevention of acute coronary syndrome.

Accreditations & Approvals

In support of improving patient care, NetCE is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team. NetCE is approved by the California Nursing Home Administrator Program as a provider of continuing education. Provider number 1622. NetCE is approved to offer continuing education through the Florida Board of Nursing Home Administrators, Provider #50-2405. NetCE is accredited by the International Accreditors for Continuing Education and Training (IACET). NetCE complies with the ANSI/IACET Standard, which is recognized internationally as a standard of excellence in instructional practices. As a result of this accreditation, NetCE is authorized to issue the IACET CEU.

Designations of Credit

This activity was planned by and for the healthcare team, and learners will receive 15 Interprofessional Continuing Education (IPCE) credit(s) for learning and change. NetCE designates this continuing education activity for 15 ANCC contact hour(s). NetCE designates this continuing education activity for 10 pharmacotherapeutic/pharmacology contact hour(s). NetCE designates this continuing education activity for 18 hours for Alabama nurses. This home study course is approved by the Florida Board of Nursing Home Administrators for 15 credit hour(s). This course is approved by the California Nursing Home Administrator Program for 10 hour(s) of continuing education credit - NHAP#1622010-9429/P. California NHAs may only obtain a maximum of 10 hours per course. NetCE is authorized by IACET to offer 1.5 CEU(s) for this program. AACN Synergy CERP Category A.

Individual State Nursing Approvals

In addition to states that accept ANCC, NetCE is approved as a provider of continuing education in nursing by: Alabama, Provider #ABNP0353, (valid through July 29,2025); Alabama, Provider #ABNP0353, (valid through July 29, 2025); Arkansas, Provider #50-2405; California, BRN Provider #CEP9784; California, LVN Provider #V10662; California, PT Provider #V10842; District of Columbia, Provider #50-2405; Florida, Provider #50-2405; Georgia, Provider #50-2405; Kentucky, Provider #7-0054 through 12/31/2025; South Carolina, Provider #50-2405; South Carolina, Provider #50-2405. West Virginia RN and APRN, Provider #50-2405.

Course Objective

The pace at which guidelines for acute coronary syndrome are updated make it challenging for clinicians to remain current with the recommendations that lead to improved outcomes for this substantial patient population. The purpose of this course is to reduce the widening gap between care according to guidelines and actual care delivered by providing nurses with knowledge necessary to implement the most appropriate approach to diagnosis and treatment.

Learning Objectives

Upon completion of this course, you should be able to:

  1. Explain the pathophysiology of ACS, including the role of plaque formation and rupture.
  2. Discuss risk factors and key aspects of screening for atherosclerotic plaque and coronary heart disease (CHD).
  3. Describe components of triaging patients with suspected ACS.
  4. Identify key elements that should be included in the history and physical examination of patients with suspected ACS, including the role of stress tests.
  5. List key elements to include in chest pain assessment for a patient with possible ACS.
  6. Outline the role of 12-lead ECG and cardiac biomarkers in the diagnosis and risk stratification of ACS.
  7. Review key recommendations for the medical and nursing management of patients with UA/NSTEMI, including initial treatment, early inpatient care, and recommended pharmacotherapy.
  8. Describe ischemia-guided and invasive strategies related to the management of patients with UA/NSTEMI.
  9. Discuss key components of medical and nursing management of patients with variant angina and cocaine-induced ACS.
  10. Explain the role of PCI in the management of STEMI, including the issues of timing, stent selection, supporting pharmacologic therapy, risks, and possible complications.
  11. Outline the use of fibrinolytic therapy as a reper­fusion therapy in the management of STEMI, including the issues of indications, contraindications, supporting pharmacologic therapy, and risks.
  12. List key measures used to prevent reocclusion in coronary circulation following reperfusion with PCI or fibrinolytic therapy.
  13. Discuss the role of smoking cessation in reducing the risk of recurrent ACS and tools for helping patients quit smoking.
  14. Describe other measures patients may take to reduce risk of recurrent ACS and ongoing CHD from hypertension, dyslipidemia, and other modifiable risk factors.
  15. Explain factors that impact a patient's adherence to prescribed therapy and measures to reduce risk of recurrent coronary disease.


Karen Majorowicz, RN, is currently employed in the Cardiac Intermediate Care Unit at Shands Healthcare at the University of Florida, Gainesville. She received her Master's in Medical-Surgical Nursing in 1978 from the University of Maryland. Karen has created numerous instructional manuals on Medicare and has conducted educational programs on cardiovascular assessment.

Lori L. Alexander, MTPW, ELS, MWC, is President of Editorial Rx, Inc., which provides medical writing and editing services on a wide variety of clinical topics and in a range of media. A medical writer and editor for more than 30 years, Ms. Alexander has written for both professional and lay audiences, with a focus on continuing education materials, medical meeting coverage, and educational resources for patients. She is the Editor Emeritus of the American Medical Writers Association (AMWA) Journal, the peer-review journal representing the largest association of medical communicators in the United States. Ms. Alexander earned a Master’s degree in technical and professional writing, with a concentration in medical writing, at Northeastern University, Boston. She has also earned certification as a life sciences editor and as a medical writer.

Faculty Disclosure

Contributing faculty, Karen Majorowicz, RN, has disclosed no relevant financial relationship with any product manufacturer or service provider mentioned.

Contributing faculty, Lori L. Alexander, MTPW, ELS, MWC, has disclosed no relevant financial relationship with any product manufacturer or service provider mentioned.

Division Planner

Jane C. Norman, RN, MSN, CNE, PhD

Division Planner Disclosure

The division planner has disclosed no relevant financial relationship with any product manufacturer or service provider mentioned.

Director of Development and Academic Affairs

Sarah Campbell

Director Disclosure Statement

The Director of Development and Academic Affairs has disclosed no relevant financial relationship with any product manufacturer or service provider mentioned.

About the Sponsor

The purpose of NetCE is to provide challenging curricula to assist healthcare professionals to raise their levels of expertise while fulfilling their continuing education requirements, thereby improving the quality of healthcare.

Our contributing faculty members have taken care to ensure that the information and recommendations are accurate and compatible with the standards generally accepted at the time of publication. The publisher disclaims any liability, loss or damage incurred as a consequence, directly or indirectly, of the use and application of any of the contents. Participants are cautioned about the potential risk of using limited knowledge when integrating new techniques into practice.

Disclosure Statement

It is the policy of NetCE not to accept commercial support. Furthermore, commercial interests are prohibited from distributing or providing access to this activity to learners.

Technical Requirements

Supported browsers for Windows include Microsoft Internet Explorer 9.0 and up, Mozilla Firefox 3.0 and up, Opera 9.0 and up, and Google Chrome. Supported browsers for Macintosh include Safari, Mozilla Firefox 3.0 and up, Opera 9.0 and up, and Google Chrome. Other operating systems and browsers that include complete implementations of ECMAScript edition 3 and CSS 2.0 may work, but are not supported. Supported browsers must utilize the TLS encryption protocol v1.1 or v1.2 in order to connect to pages that require a secured HTTPS connection. TLS v1.0 is not supported.

Implicit Bias in Health Care

The role of implicit biases on healthcare outcomes has become a concern, as there is some evidence that implicit biases contribute to health disparities, professionals' attitudes toward and interactions with patients, quality of care, diagnoses, and treatment decisions. This may produce differences in help-seeking, diagnoses, and ultimately treatments and interventions. Implicit biases may also unwittingly produce professional behaviors, attitudes, and interactions that reduce patients' trust and comfort with their provider, leading to earlier termination of visits and/or reduced adherence and follow-up. Disadvantaged groups are marginalized in the healthcare system and vulnerable on multiple levels; health professionals' implicit biases can further exacerbate these existing disadvantages.

Interventions or strategies designed to reduce implicit bias may be categorized as change-based or control-based. Change-based interventions focus on reducing or changing cognitive associations underlying implicit biases. These interventions might include challenging stereotypes. Conversely, control-based interventions involve reducing the effects of the implicit bias on the individual's behaviors. These strategies include increasing awareness of biased thoughts and responses. The two types of interventions are not mutually exclusive and may be used synergistically.