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17 - Acute Coronary Syndrome

from Section 4 - Cardiovascular Emergencies

Published online by Cambridge University Press:  02 November 2023

By
Steven C. Rougas
Edited by
Kaushal Shah  and
Jarone Lee
Edited in association with
Clark G. Owyang  and
Benjamin Christian Renne
Kaushal Shah
Affiliation:
Weill Cornell Medical Center, New York
Jarone Lee
Affiliation:
Massachusetts General Hospital, Boston
Clark G. Owyang
Affiliation:
Weill Cornell Medical Center, New York
Benjamin Christian Renne
Affiliation:
Massachusetts General Hospital, Boston
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Summary

  • Ischemic heart disease is the leading noninfectious cause of death in adults in the United States.

  • Acute coronary syndrome (ACS) refers to symptoms attributable to atherosclerotic disease of the epicardial coronary arteries, usually caused by a fixed atherosclerotic lesion of varying severity.

  • ACS is a spectrum of disease and can present as acute myocardial infarction (AMI) or unstable angina (UA). AMI is myocardial ischemia with necrosis and can occur with or without ST segment elevation. The latter is referred to as non-ST-segment elevation myocardial infarction (NSTEMI). UA is reversible myocardial ischemia without necrosis.

Keywords

myocardial infarctionanginaaspirinECGchest pain
Type
Chapter
Information
Practical Emergency Resuscitation and Critical Care , pp. 149 - 158
Publisher: Cambridge University Press
Print publication year: 2023

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References

Brady, WJ, Harrigan, RA, Chan, TC. Acute coronary syndrome. In: Marx, JA, Hockberger, RS, Walls, RM, et al., eds. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, PA: Mosby Elsevier, 2010.Google Scholar
Hollander, JE, Diercks, DB. Acute coronary syndromes: Acute myocardial infarction and unstable angina. In: Tintinalli, JE, Stapczynski, JS, Ma, OJ, et al., eds. Tintinalli’s Emergency Medicine: A Comprehensive Study Guide. 7th ed. New York, NY: McGraw-Hill, 2011.Google Scholar
Hollenberg, SM, Parrillo, JE. Myocardial ischemia. In: Hall, JB, Schmidt, GA, Wood, LD, eds. Principles of Critical Care. 3rd ed. New York, NY: McGraw-Hill, 2005.Google Scholar
Thygesen, K, Alpert, JS, Jaffe, AS, et al. Fourth universal definition of myocardial infarction. J Am Coll Cardiol 2018;72(18):2231–2264. https://doi.org/10.1016/j.jacc.2018.08.1038CrossRefGoogle ScholarPubMed

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