Document Detail


Acute coronary syndromes: diagnosis and management, part I.
MedLine Citation:
PMID:  19797781     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The term acute coronary syndrome (ACS) refers to any group of clinical symptoms compatible with acute myocardial ischemia and includes unstable angina (UA), non-ST-segment elevation myocardial infarction (NSTEMI), and ST-segment elevation myocardial infarction (STEMI). These high-risk manifestations of coronary atherosclerosis are important causes of the use of emergency medical care and hospitalization in the United States. A quick but thorough assessment of the patient's history and findings on physical examination, electrocardiography, radiologic studies, and cardiac biomarker tests permit accurate diagnosis and aid in early risk stratification, which is essential for guiding treatment. High-risk patients with UA/NSTEMI are often treated with an early invasive strategy involving cardiac catheterization and prompt revascularization of viable myocardium at risk. Clinical outcomes can be optimized by revascularization coupled with aggressive medical therapy that includes anti-ischemic, antiplatelet, anticoagulant, and lipid-lowering drugs. Evidence-based guidelines provide recommendations for the management of ACS; however, therapeutic approaches to the management of ACS continue to evolve at a rapid pace driven by a multitude of large-scale randomized controlled trials. Thus, clinicians are frequently faced with the problem of determining which drug or therapeutic strategy will achieve the best results. This article summarizes the evidence and provides the clinician with the latest information about the pathophysiology, clinical presentation, and risk stratification of ACS and the management of UA/NSTEMI.
Authors:
Amit Kumar; Christopher P Cannon
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Mayo Clinic proceedings     Volume:  84     ISSN:  1942-5546     ISO Abbreviation:  Mayo Clin. Proc.     Publication Date:  2009 Oct 
Date Detail:
Created Date:  2009-10-02     Completed Date:  2009-10-22     Revised Date:  2013-12-13    
Medline Journal Info:
Nlm Unique ID:  0405543     Medline TA:  Mayo Clin Proc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  917-38     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Acute Coronary Syndrome / diagnosis*,  etiology,  therapy*
Angina, Unstable / etiology,  pathology,  physiopathology
Biological Markers / metabolism
Coronary Artery Disease / complications,  pathology,  therapy
Critical Pathways
Emergency Service, Hospital / organization & administration
Humans
Myocardial Infarction / diagnosis*,  etiology,  therapy*
Risk Assessment
Chemical
Reg. No./Substance:
0/Biological Markers
Comments/Corrections

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