Abstract

March 2007

Section 1 Cardiovascular Medicine

Acute coronary syndrome is the constellation of symptoms, signs, and electrocardiographic and laboratory findings associated with new-onset or worsening myocardial ischemia. It includes the spectrum of acute ST segment-elevation myocardial infarction (MI) with or without Q waves, non-ST segment elevation MI (NSTEMI), and unstable angina. The main difference between NSTEMI and unstable angina is that in NSTEMI the severity of ischemia is sufficient to cause cardiac enzyme elevation and tissue injury, but this difference may not be apparent on initial presentation. This chapter discusses the pathophysiology, presentation, diagnosis, (including use of cardiac biomarkers and risk stratification), and treatment of unstable angina or NSTEMI. Initial therapy and the choice between an early invasive and an early conservative therapeutic strategy are explained. Figures describe the diagnosis and management steps. Tables describe clinical factors for determining diagnosis and prognosis, the Thrombolysis in Myocardial Infarction (TIMI) risk score, and the use of drugs in antiplatelet, anticoagulant, and anti-ischemic therapy for unstable angina or NSTEMI. This chapter has 86 references.

© 2007 WebMD Inc. All Rights Reserved.

WebMD Professional Publishing, P.O. Box 1819, Danbury CT 06813 (800-545-0554 or 203-790-2087)