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should be provided in a simple and clear format. In patients undergoing emergency invasive angiography, a shortened informed consent process is appropriate. If a shortened informed consent process has been used, it is important that there is contact with the patient and/ or family member after the intervention when the patient is physically and psychologically stable or following the death of the patient.892 Further information can be found in the Supplementary data online.

14.4 Research participation and consent in

the acute setting With unstable ACS patients, it is often challenging to obtain their consent for emergency procedures—and even more challenging to enrol in clinical trials due to a number of factors, including the necessity for prompt clinical care, increased pain and stress levels, and impairment of consciousness. Where clinical trials are conducted, patient involvement in enrolment decisions is paramount, if possible.893,894 A short witnessed verbal consent, followed by written consent after the acute phase, has been shown to be less stressful and more positively received than written consent in the acute setting.894 The research and consent process must follow the ethical and legal requirements in the relevant country. Further information can be found in the Supplementary data online.

14.5 Patient satisfaction and expectations

Focusing healthcare around the needs and preferences of patients has the potential to improve clinical outcomes, quality of care and patient satisfaction, while decreasing healthcare costs and health disparities.881 Patient perception of care is built on interpersonal interactions, the quality of clinical communication, delivery of care, and the administrative management of care. ACS patient expectations are summarized in Figure 20 and further information can be found in the Supplementary data online, Table S19.

...their ACS symptoms

to be recognised ...high quality, effective and safe care delivered

by professionals ...the right care at the right time

...their physical, mental and emotional wellbeing

to be considered ...clear, comprehensible

information ...shared decision making and respect for their preferences

...consideration of,

and support for, their family and carers ...attention to both

their physical and environmental needs ...a clean and safe hospital environment

ACS patients expect...

Figure 20 Acute coronary syndrome patient expectations. ACS, acute coronary syndrome. Downloaded from academic.oup.com/eurheartj/article/44/38/3720/7243210 by guest on 07 October 2026