Not usually a concern unless the patient becomes unresponsive (a late sign of serious organ failure)

Patient may present with:

• Breathlessness and raised respiratory rate.

• On auscultation: You may hear bilateral basal crackles due to acute pulmonary oedema.

• Oxygen saturations may drop (hypoxia) if the patient develops acute pulmonary oedema.

The patient may present with:

• Hypotension and tachycardia due to impaired cardiac contractility secondary to ischaemia (cardiogenic shock).

• Can also present with bradycardia.

• Arrhythmias can be caused by myocardial ischaemia.

• Weak or absent peripheral pulses.

• Peripherally cool, clammy to touch and delayed CRT.

• Reduced urine output.

The patient may present with:

• Acute chest pain, may feel like a crushing or constricting pain, may radiate to shoulder, neck, jaw or back.

• Confusion, drowsiness, agitation due to reduced blood flow to brain if in cardiogenic shock.

• Feeling of impending doom.

• Nausea and vomiting.

Peripheral oedema may be present.