ACUTE CORONARY SYNDROME (ACS)

SUMMARY

1. The acute coronary syndromes, ST elevation myocardial infarction (STEMI) and non–ST elevation myocardial infarction (NSTEMI), are commonly related to atherothrombotic stenosis of the epicardial coronary arteries.

2. They are classified as Type 1 myocardial infarctions.

3. Pathology: atherosclerotic plaque rupture, fissuring, erosion, with superimposed intra-coronary thrombosis; results in acute ischemia; and is assoc. with MI & cardiac death.

4. Rarely, ACS can be due to occlusion by coronary emboli, congenital abnormalities, coronary spasm, and systemic inflammatory diseases.

5. Patients with NSTEMI have a smaller size of infarcted area and decreased early mortality compared to those with STEMI, but a higher risk for persistent angina, reinfarction, and death within several months.

Reference(s)

Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. Get it on Amazon.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].