Activity 1: Chest Pain: What to Do with ACS?

Program Overview

The spectrum of coronary diseases spanned by the umbrella term acute coronary syndrome (ACS) — unstable angina, non-ST-elevation myocardial infarction (NSTEMI) and ST-elevation myocardial infarction (STEMI)— are heterogeneous disorders in which patients have widely varying risks. Evaluation of patients with chest pain or symptoms consistent with ACS begins with risk stratification. This is a critical period of assessment, when important management decisions are made that determine a patient’s short- and long-term outcome.

In Chest Pain: What to Do with ACS?, the first video lecture of our four-part educational series on ACS, join Dr. Jasen Gundersen, a practicing family physician, as he launches our discussion into ACS. This activity will provide the foundation for subsequent programming by reviewing the pathophysiology and prevalence of ACS, the differential diagnosis and risk stratification, and evidence-based strategies for acute and post-ACS management.

Intended Audience

This continuing medical education program is intended for family physicians and other primary care providers who care for patients with acute coronary syndrome (ACS).

Learning Objectives

After completing this activity, family physicians will be better able to:

• Use TIMI or GRACE risk models to stratify ACS patients according to individual risk
• Employ physical findings, serum biomarkers and initial ECG results to diagnose patients with ACS
• Apply evidence-based treatment recommendations in the acute and post-event phases of ACS care
• Communicate with patients concerning their ACS risk, presentation of ACS and importance of compliance with recommended treatment

Faculty

Jasen W. Gundersen, MD, MBA, SFHM
Inpatient Clinical Services Chief
Division Chief, Hospital Medicine
UMass Memorial Medical Center
Clinical Associate Professor of Medicine and Family & Community Health
UMass Medical School
Worcester, MA

Planning Committee

Sharon K. Duffy, RN, MS, CRRN
Manager Integrative Medicine
Madonna ProActive Health & Fitness
Lincoln, NE

Kim A. Eagle, MD, MACC
Albion Walter Hewlett Professor of Internal Medicine and Director
Cardiovascular Center
University of Michigan Health System
Ann Arbor, MI

Clare A. Hawkins, MD MSc. FAAFP- Chair
Family Medicine Residency Director
San Jacinto Methodist Hospital
Baytown, TX

Jasen W. Gundersen, MD, MBA, SFHM
Inpatient Clinical Services Chief
Division Chief, Hospital Medicine
UMass Memorial Medical Center
Clinical Associate Professor of Medicine and Family & Community Health
UMass Medical School
Worcester, MA

CME Accreditation

This activity has been reviewed and is acceptable for up to .75 Prescribed credits by the American Academy of Family Physicians. AAFP accreditation begins August 1, 2010. Term of approval is for two years from this date with the option of yearly renewal. These Prescribed credits conform to the AAFP criteria for evidence-based CME clinical content. It is not necessary to label credit as evidence-based CME for reporting purposes.

The EB CME credit awarded for this activity was based on practice recommendations that were the most current with the strongest level of evidence available at the time this activity was approved. Since some clinical research is ongoing, the American Academy of Family Physicians recommends that learners verify sources and review these and other recommendations prior to implementation into practice.

The AAFP is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The American Academy of Family Physicians designates this education activity for a maximum of .75 AMA PRA Category 1 credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Agenda

Introduction and Opening Remarks

Module 1: Pathophysiology, Prevalence and Risk of ACS

Module 2: Diagnosing ACS

Module 3: Acute Care for ACS

Closing Remarks

Disclosures

It is the policy of the AAFP that all CME planning committee/faculty/authors/editors/staff disclose relationships with commercial entities upon nomination/invitation of participation. Disclosure documents are reviewed for potential conflict of interests and, if identified, they are resolved prior to confirmation of participation. Only these participants who have no conflict of interest or who agree to an identified resolution process prior to their participation were involved in this CME activity.

The AAFP and MedEd Architects, LLC staffs have indicated that they have no relationships to disclose relating to the subject matter of the activity. Dr. Gundersen has returned a disclosure form indicating that he has no financial interest in or affiliation with any commercial supporter or providers of any commercial services discussed in this educational material.

Please note that faculty is required to disclose all relevant relationships prior to the beginning of the activity.