CVS » Vascular disease » IHD

Acute Coronary Syndrome

Patients with ACS include those whose clinical presentations cover the following range of diagnoses: Unstable angina, Non ST-elevation myocardial infarction (NSTEMI) and ST-elevation myocardial infarction (STEMI). Atherosclerotic plaque is the predominant cause. Coronary artery vasospasm is less common Creatine kinase fraction (CK-MB) is the standard criterion for detection of MI; CK-MB levels in acute myocardial infarction (AMI) begin to rise within 4 hours of injury, peak at 18-24 hours, and subside over 3-4 days Antithrombin therapy and antiplatelet therapy should be administered to all patients with an ACS regardless of the presence or absence of ST-segment elevation. Patients presenting with persistent ST-segment elevation are candidates for reperfusion therapy (either pharmacological or catheter-based) to restore flow promptly in the occluded epicardial infarct-related artery. Patients presenting without ST-segment elevation are not candidates for immediate pharmacological reperfusion but should receive anti-ischaemic therapy and catheter-based therapy when appropriate.

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