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A 58-year-old man comes to the emergency department (ED) in the early afternoon with a 2-day history of severe chest pain. The pain started on wakening the previous day. He comes to the ED today because the pain is severe and no longer relieved by rest. His father died of a heart attack at age 62; he smokes one pack of cigarettes per day; and,he describes his lifestyle as sedentary.

  • Blood pressure 180/96, pulse 98, temperature 99.8° F, respirations 20
  • Height 5’11”, weight 210 lbs, BMI 29.3 kg/m2
  • Skin diaphoretic and clammy
  • Heart rhythm regular, no murmurs or extra heart sounds
  • Cardiac markers and Electrocardiogram (EKG)—pending

1. Discuss the spectrum of acute coronary syndrome. 2.What would you anticipate this patient’s cardiac markers and electrocardiogram could potentially reveal?

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3.Describe the healing process that occurs in the infarcted myocardium, identifying vulnerable periods during the healing process.

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