Acute Coronary Syndrome

Acute Coronary Syndrome is a term that refers to two types of disease processes that lead to myocardial injury:
 * Acute Myocardial Infarction (60%):
 * STEMI
 * NSTEMI
 * Unstable Angina (40%)

=Objectives=
 * Understand how to use cardiac biomarkers to differentiate unstable angina from acute myocardial infarction.
 * Determine if a patient's chest pain is cardiac in nature.
 * Familiarize yourself with how important it is to move quickly in a patient with myocardial injury.
 * Recognize why the TIMI score is important.

=Symptoms=
 * Angina


 * Dyspnea


 * Diaphoresis


 * Nausea and Vomiting

=Mechanism= Most cases are due to atheroembolism. Other causes include spasm of the coronary arteries (Prinzmetal's angina), vasculitis, aortic dissection that involves coronary arteries, demand ischemia, or myocarditis.

=Differential Diagnosis=
 * Coronary vasospasm


 * Coronary artery embolism


 * Demand ischemia


 * Myocarditis

=Diagnostic Workup=
 * 1) Physical Exam
 * ECG
 * 1) ECHO
 * 2) Cardiac Biomarkers

=Management= The two options are medical mangement or surgical management. STEMI patients should receive surgical intervention. Unstable and NSTEMI can managed medically or surgically. The decision between surgical and medical management is determined after calculating the TIMI score.

=Pimping Points=

=Floor Fodder=

=Study Questions=