| Acute coronary syndromes: diagnosis and management, part I. | |
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MedLine Citation:
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PMID: 19797781 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Amit Kumar; Christopher P Cannon |
Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: Mayo Clinic proceedings. Mayo Clinic Volume: 84 ISSN: 1942-5546 ISO Abbreviation: Mayo Clin. Proc. Publication Date: 2009 Oct |
Date Detail:
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Created Date: 2009-10-02 Completed Date: 2009-10-22 Revised Date: 2010-09-27 |
Medline Journal Info:
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Nlm Unique ID: 0405543 Medline TA: Mayo Clin Proc Country: United States |
Other Details:
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Languages: eng Pagination: 917-38 Citation Subset: AIM; IM |
Affiliation:
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Department of Hospital Medicine, University of Massachusetts Medical School, Worcester, MA 01655, USA. amkrdoc@gmail.com |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Acute Coronary Syndrome
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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:
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0/Biological Markers |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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