Acute coronary syndrome
Table of contents
- Essentials
- Symptoms and clinical diagnosis
- Diagnostic investigations
- Initial management evd
- Treatment of UAP and NSTEMI
- Treatment of STEMI
- Arrhythmias associated with myocardial infarction
- Right ventricular infarction
- Acute coronary syndrome triggered by other factors
- Inpatient treatment
- Follow-up management
- References
Extract
- Acute coronary syndrome (ACS) results from a local reduction or cessation of blood flow in a coronary artery. This is most often caused by a sudden thrombus formation associated with rupture or erosion of an atherosclerotic plaque in the coronary artery wall.
- In the absence of an acute atherothrombotic coronary stenosis, imbalance between the myocardial oxygen need and the availability of oxygen, and consequently myocardial ischaemia, may also be caused by conditions such as tachycardia or bradycardia, coronary spasm, hypotension, anaemia, respiratory insufficiency or other severe disease, such as sepsis.
- Classification of ACS
- Unstable angina (pectoris, UAP)
- Non ST elevation myocardial infarction (NSTEMI)
- ST elevation myocardial infarction (STEMI)
Linked evidence summaries
- Low-molecular weight heparins are superior to placebo and unfractionated heparin in acute coronary syndromes (unstable angina or non-ST segment elevation myocardial infarction).A
- ACE inhibitors administered within 24 hours of symptom onset and continued for 10 days significantly reduce day 10 all-cause mortality (2 to 4 deaths prevented per 1000) in acute myocardial infarction.A
- Nicotine replacement therapy (NRT) in different forms is effective for smoking cessation. NRT increases quit rate approximately 1.5 to 2 fold. Combination nicotine replacement therapy is as effective as varenicline.A
- In patients with cardiovascular disease, influenza vaccination may reduce cardiovascular mortality and combined cardiovascular events. There is insufficient evidence whether influenza vaccination has a role to play in the primary prevention of cardiovascular disease.C
Search terms
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