ACUTE CORONARY SYNDROMES: Acute Myocardial Infarction and Unstable Angina

Posted by e-Medical PPT Saturday, September 4, 2010
Acute coronary syndrome (ACS) is a syndrome related to the heart.Acute coronary syndrome further dividied into unstable angina and two forms of myocardial infarction.These two forms of myocardial infarction are named according to the appearance of the electrocardiogram as non-ST segment elevation myocardial infarction (NSTEMI) and ST segment elevation myocardial infarction (STEMI).
ACS should be distinguished from stable angina, which develops during exertion and resolves at rest. In contrast with stable angina, unstable angina occurs suddenly, often at rest or with minimal exertion, or at lesser degrees of exertion than the individual's previous angina ("crescendo angina"). ACS is usually caused by coronary thrombosis, but it can also be associated with cocaine use.Cardiac chest pain can also be precipitated by anemia, bradycardias or tachycardia.The cardinal sign of ACS is chest pain experienced as tightness around the chest and radiating to the left arm and the left angle of the jaw. This may be associated with sweating, nausea and vomiting, as well as shortness of breath.
In the setting of acute chest pain, the electrocardiogram is the investigation that most reliably distinguishes between various causes.If this indicates acute heart damage (elevation in the ST segment, new left bundle branch block), treatment for a heart attack in the form of angioplasty or thrombolysis is indicated immediately.In the absence of such changes, it is not possible to immediately distinguish between unstable angina and NSTEMI.Acute coronary syndrome often reflects a degree of obstruction of coronaries by atherosclerosis.Primary prevention of atherosclerosis is controlling its risk factors: healthy eating, exercise, treatment for hypertension and diabetes, avoiding smoking and controlling cholesterol levels.

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