Acute coronary syndromes: Difference between revisions
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Acute coronary syndrome(ACS) refers to any group of symptoms attributed to obstruction of the [[coronary artery|coronary arteries]]. The most common symptom prompting diagnosis of ACS is [[chest pain]], often radiating of the left arm or angle of the jaw, pressure-like in character, and associated with nausea and sweating. Acute coronary syndrome usually occurs as a result of one of three problems: [[ST-elevation myocardial infarction]] (30%), [[non ST-elevation myocardial infarction]] (25%), or [[unstable angina]] (38%).<ref>{{cite journal |author=Torres M, Moayedi S |title=Evaluation of the acutely dyspneic elderly patient |journal=Clin. Geriatr. Med. |volume=23 |issue=2 |pages=307–25, vi |year=2007 |month=May |pmid=17462519 |doi=10.1016/j.cger.2007.01.007 |url=}}</ref> These types are named according to the appearance of the [[electrocardiogram]].<ref name="pmid12791748">{{cite journal |author=Grech ED, Ramsdale DR |title=Acute coronary syndrome: unstable angina and non-ST segment elevation myocardial infarction |journal=BMJ |volume=326 |issue=7401 |pages=1259–61 |year=2003 |month=June |pmid=12791748 |pmc=1126130 |doi=10.1136/bmj.326.7401.1259 |url=http://bmj.com/cgi/pmidlookup?view=long&pmid=12791748}}</ref> There can be some variation as to which forms of [[myocardial infarction]] (MI) are classified under acute coronary syndrome.<ref name="urlDorlands Medical Dictionary:acute coronary syndrome">{{cite web |url=http://www.mercksource.com/pp/us/cns/cns_hl_dorlands_split.jsp?pg=/ppdocs/us/common/dorlands/dorland/nine/14170699.htm |title=Dorlands Medical Dictionary:acute coronary syndrome |work= |accessdate=}}</ref> | Acute coronary syndrome(ACS) refers to any group of symptoms attributed to obstruction of the [[coronary artery|coronary arteries]]. The most common symptom prompting diagnosis of ACS is [[chest pain]], often radiating of the left arm or angle of the jaw, pressure-like in character, and associated with nausea and sweating. Acute coronary syndrome usually occurs as a result of one of three problems: [[ST-elevation myocardial infarction]] (30%), [[non ST-elevation myocardial infarction]] (25%), or [[unstable angina]] (38%).<ref>{{cite journal |author=Torres M, Moayedi S |title=Evaluation of the acutely dyspneic elderly patient |journal=Clin. Geriatr. Med. |volume=23 |issue=2 |pages=307–25, vi |year=2007 |month=May |pmid=17462519 |doi=10.1016/j.cger.2007.01.007 |url=}}</ref> These types are named according to the appearance of the [[electrocardiogram]].<ref name="pmid12791748">{{cite journal |author=Grech ED, Ramsdale DR |title=Acute coronary syndrome: unstable angina and non-ST segment elevation myocardial infarction |journal=BMJ |volume=326 |issue=7401 |pages=1259–61 |year=2003 |month=June |pmid=12791748 |pmc=1126130 |doi=10.1136/bmj.326.7401.1259 |url=http://bmj.com/cgi/pmidlookup?view=long&pmid=12791748}}</ref> There can be some variation as to which forms of [[myocardial infarction]] (MI) are classified under acute coronary syndrome.<ref name="urlDorlands Medical Dictionary:acute coronary syndrome">{{cite web |url=http://www.mercksource.com/pp/us/cns/cns_hl_dorlands_split.jsp?pg=/ppdocs/us/common/dorlands/dorland/nine/14170699.htm |title=Dorlands Medical Dictionary:acute coronary syndrome |work= |accessdate=}}</ref> | ||
ACS should be distinguished from [[Chronic stable angina|stable angina]], which is chest pain which develops during exertion and resolves at rest. New onset angina however should be considered as a part of acute coronary syndrome, since it suggests a new problem in a coronary artery. | ACS should be distinguished from [[Chronic stable angina|stable angina]], which is chest pain which develops during exertion and resolves at rest. New onset angina however should be considered as a part of acute coronary syndrome, since it suggests a new problem in a coronary artery.Though ACS is usually associated with [[coronary thrombosis]], it can also be associated with [[cocaine]] use.<ref>{{cite journal |author=Achar SA, Kundu S, Norcross WA |title=Diagnosis of acute coronary syndrome |journal=Am Fam Physician |volume=72 |issue=1 |pages=119–26 |year=2005 |pmid=16035692 |doi= |url=http://www.aafp.org/afp/20050701/119.html}}</ref> Cardiac chest pain can also be precipitated by [[anemia]], [[bradycardia]]s (excessively slow heart rate) or [[tachycardia]]s (excessively fast heart rate). | ||
Though ACS is usually associated with [[coronary thrombosis]], it can also be associated with [[cocaine]] use.<ref>{{cite journal |author=Achar SA, Kundu S, Norcross WA |title=Diagnosis of acute coronary syndrome |journal=Am Fam Physician |volume=72 |issue=1 |pages=119–26 |year=2005 |pmid=16035692 |doi= |url=http://www.aafp.org/afp/20050701/119.html}}</ref> Cardiac chest pain can also be precipitated by [[anemia]], [[bradycardia]]s (excessively slow heart rate) or [[tachycardia]]s (excessively fast heart rate). | |||
==Acute Coronary Syndrome== | ==Acute Coronary Syndrome== | ||
Revision as of 17:44, 13 February 2013
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Acute coronary syndrome(ACS) refers to any group of symptoms attributed to obstruction of the coronary arteries. The most common symptom prompting diagnosis of ACS is chest pain, often radiating of the left arm or angle of the jaw, pressure-like in character, and associated with nausea and sweating. Acute coronary syndrome usually occurs as a result of one of three problems: ST-elevation myocardial infarction (30%), non ST-elevation myocardial infarction (25%), or unstable angina (38%).[1] These types are named according to the appearance of the electrocardiogram.[2] There can be some variation as to which forms of myocardial infarction (MI) are classified under acute coronary syndrome.[3]
ACS should be distinguished from stable angina, which is chest pain which develops during exertion and resolves at rest. New onset angina however should be considered as a part of acute coronary syndrome, since it suggests a new problem in a coronary artery.Though ACS is usually associated with coronary thrombosis, it can also be associated with cocaine use.[4] Cardiac chest pain can also be precipitated by anemia, bradycardias (excessively slow heart rate) or tachycardias (excessively fast heart rate).
Acute Coronary Syndrome
Acute coronary syndrome may refer to either of the three conditions listed below. For detailed information on the specific type of acute coronary syndrome, click on the links.
Diagnosis Using the Clinical Prediction Rule [5][6]
Guidelines for Risk Stratification
Guidelines for Pre-hospital Evaluation and Care
Guidelines for Initial Management
References
- ↑ Torres M, Moayedi S (2007). "Evaluation of the acutely dyspneic elderly patient". Clin. Geriatr. Med. 23 (2): 307–25, vi. doi:10.1016/j.cger.2007.01.007. PMID 17462519. Unknown parameter
|month=ignored (help) - ↑ Grech ED, Ramsdale DR (2003). "Acute coronary syndrome: unstable angina and non-ST segment elevation myocardial infarction". BMJ. 326 (7401): 1259–61. doi:10.1136/bmj.326.7401.1259. PMC 1126130. PMID 12791748. Unknown parameter
|month=ignored (help) - ↑ "Dorlands Medical Dictionary:acute coronary syndrome".
- ↑ Achar SA, Kundu S, Norcross WA (2005). "Diagnosis of acute coronary syndrome". Am Fam Physician. 72 (1): 119–26. PMID 16035692.
- ↑ Christenson J, Innes G, McKnight D, Thompson CR, Wong H, Yu E; et al. (2006). "A clinical prediction rule for early discharge of patients with chest pain". Ann Emerg Med. 47 (1): 1–10. doi:10.1016/j.annemergmed.2005.08.007. PMID 16387209.
- ↑ Jalili M, Hejripour Z, Honarmand AR, Pourtabatabaei N (2012). "Validation of the vancouver chest pain rule: a prospective cohort study". Acad Emerg Med. 19 (7): 837–42. doi:10.1111/j.1553-2712.2012.01399.x. PMID 22805631.