NetCE - Continuing Education Online
Home About NetCE Staff & Faculty  Contact  Us 
Read course content

Course # 40942 • Acute Coronary Syndrome


Acute coronary syndrome (ACS) is a spectrum of life-threatening disorders that includes unstable angina (UA), non-ST-segment elevation MI (NSTEMI), and ST-segment elevation MI (STEMI). Mortality rates have declined considerably over the past decade as therapeutic options have expanded and evidence-based guidelines have been developed for the diagnosis and treatment of NSTEMI and STEMI. The course begins by providing a context for ACS through a discussion of the epidemiology of coronary heart disease (CHD) and ACS, a description of the pathophysiology of ACS, and the primary prevention of CHD, which helps to lower the prevalence of ACS. The course then focuses on the diagnosis of UA/NSTEMI and STEMI and risk stratification in the emergency department setting. Although many of the same classes of drugs are used to treat UA/NSTEMI and STEMI, the therapeutic approaches vary considerably. The treatment of ACS is a complex issue because of the wide scope of cardiac disease related to ACS and the extensive treatment decisions involved. As such, the content is limited to an overview of the diagnosis, treatment, and secondary prevention in an uncomplicated course of ACS.

Learning Tools
Use these tools to enrich your learning experience!
Evidence Based IconView the Evidence-Based Practice Recommendations to determine the validity or relevance of the information.
Study PointsUse this objective-based question and answer exercise to enhance your course knowledge.

Education Category: Medical / Surgical

Release Date: 07/01/2018

Expiration Date: 06/30/2021


This course is designed for physicians, physician assistants, and nurse practitioners to enhance their knowledge of the diagnosis, assessment, management, and secondary prevention of acute coronary syndrome.


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 accredited by the International Association 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

NetCE designates this enduring material for a maximum of 15 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 15 MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit. Completion of this course constitutes permission to share the completion data with ACCME. This activity has been approved for the American Board of Anesthesiology’s® (ABA) requirements for Part II: Lifelong Learning and Self-Assessment of the American Board of Anesthesiology’s (ABA) redesigned Maintenance of Certification in Anesthesiology Program® (MOCA®), known as MOCA 2.0®. Please consult the ABA website,, for a list of all MOCA 2.0 requirements. Maintenance of Certification in Anesthesiology Program® and MOCA® are registered certification marks of the American Board of Anesthesiology®. MOCA 2.0® is a trademark of the American Board of Anesthesiology®. This activity has been designated for 15 Lifelong Learning (Part II) credits for the American Board of Pathology Continuing Certification Program. NetCE is authorized by IACET to offer 1.5 CEU(s) for this program.

Special Approvals

This activity is designed to comply with the requirements of California Assembly Bill 1195, Cultural and Linguistic Competency.

Course Objective

The pace at which acute coronary syndrome guidelines 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 healthcare professionals 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. Discuss the prevalence and definition of coronary heart disease (CHD) and acute coronary syndrome (ACS).
  2. Explain the pathophysiology of ACS, including the role of plaque formation and rupture.
  3. Devise a strategy for screening and evaluation of asymptomatic individuals for ACS.
  4. Describe the various clinical presentations of ACS and the differential diagnosis of chest pain, including considerations for non-English-proficient patients.
  5. More effectively utilize ECG and cardiac biomarkers in the diagnosis of ST-segment elevation myocardial infarction (STEMI) and unstable angina/non-ST-segment elevation myocardial infarction (UA/NSTEMI).
  6. Discuss the factors involved in risk stratification of individuals with suspected ACS.
  7. Assess the consistency of your and your team's adherence to guidelines for the acute treatment of UA/NSTEMI.
  8. Select the optimal anti-ischemic, antiplatelet, and anticoagulant agents for the treatment of UA/NSTEMI.
  9. Distinguish between the clinical indications for an ischemia-guided or invasive strategy for patients with UA/NSTEMI.
  10. Discuss the issue of timing in selecting reperfusion therapy for patients with STEMI.
  11. Describe the role of percutaneous coronary intervention (PCI) for STEMI.
  12. Identify contraindications and cautions for fibrinolysis in the treatment of STEMI.
  13. List other reperfusion therapies used in the treatment of STEMI, and identify the appropriate therapy for individual patients.
  14. Outline appropriate secondary prevention measures for patients with ACS.
  15. Discuss the relationship between guideline adherence in practice and patient outcomes


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

Division Planners

John M. Leonard, MD

John V. Jurica, MD, MPH

Division Planners Disclosure

The division planners have 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.

Download Course as Adobe PDF

If you do not have a PDF browser plug-in installed, right-click the "Download as Adobe PDF" link and choose "Save Target As" or "Save Link As" to download the file to your computer. The PDF may take a few seconds to generate.