Acute coronary syndrome (main)

Background

ACS is three diseases involving the coronary arteries:

1. ST-Elevation Myocardial Infarction (STEMI) (30%)
2. Non ST-Elevation Myocardial Infarction (NSTEMI) (25%)
3. Unstable Angina (38%)

DDx

• Chest Pain (DDx)
• Troponin (DDx)
• Cocaine Chest Pain
• Abdominal Pain

Diagnosis

• ECG (Diagnosis)
  • ECG is normal in 8% of all confirmed MI's
  • In LBBB see Sgarbossa's Criteria
• Cardiac Enzymes
• ACS - Risk Stratification
• ACS - Anatomical Correlation

Treatment

Intensity of Rx should be based on likelihood that sx are due to acute coronary thombosis

1. ST-Elevation Myocardial Infarction (STEMI)
2. Non ST-Elevation Myocardial Infarction (NSTEMI)
3. Unstable Angina

Disposition

• Admit all ACS pts

Prognosis

ACS - Stress Testing

See Also

• ACS - Anatomical Correlation
• ACS - Risk Stratification
• ST-Elevation Myocardial Infarction (STEMI)
• ACS - Stress Testing
• NSTEMI
• Unstable Angina