Prehospital pharmacological interventions in acute coronary syndrome

Acute coronary syndrome (ACS) is a leading cause of mortality, requiring prompt prehospital intervention. Paramedics play a key role in early recognition, pharmacological management, and risk-stratification. ACS results from myocardial ischaemia caused by atherosclerotic plaque rupture, presenting as ST elevation myocardial infarction, non-ST elevation myocardial infarction, or unstable angina. Key prehospital treatments include aspirin, glyceryl trinitrate, and morphine. Additional considerations include dual antiplatelet therapy for reperfusion, fibrinolysis when primary percutaneous coronary intervention is unavailable, selective oxygen therapy, and anti-emetics. This article reviews ACS pathophysiology and evidence-based pharmacological management in prehospital care.