RT Book, Section
A1 Auguste, Uschi
A1 Kanei, Yumiko
A2 Go, Ronaldo Collo
SR Print(0)
ID 1160186100
T1 Acute Coronary Syndromes
T2 Critical Care Examination and Board Review
YR 2019
FD 2019
PB McGraw-Hill Education
PP New York, NY
SN 9781259834356
LK accessanesthesiology.mhmedical.com/content.aspx?aid=1160186100
RD 2024/04/19
AB An  acute  coronary  syndrome  (ACS)  encompasses  a  clinical  spectrum  of  myocardial  ischemia  ranging  from  unstable  angina  (UA)  and  non–ST-segment  elevation  myocardial  infarction  (NSTEMI)  to  ST-segment  elevation  myocardial  infarction  (STEMI),  and  represents  an  acute  phase  of  coronary  atherosclerosis.1-3  Early  recognition,  diagnosis,  and  prompt  revascularization  of  the  culprit  lesion  with  percutaneous  coronary  intervention  (PCI)  is  the  contemporary  management  strategy  for  patients  presenting  with  STEMI  or  high-risk  NSTEMI.1,2,4,5  Acute  plaque  rupture  and  subsequent  atherothrombosis  with  consequent  myocardial  injury  is  the  most  common  etiology  for  ACS;  however,  myocardial  necrosis  in  the  absence  of  unstable  plaque  may  ensue  in  critically  ill  patients  who  are  admitted  for  non–cardiac-related  conditions,  such  as  pulmonary  embolism  and  septic  shock.  These  patients  pose  a  unique  diagnostic  and  management  challenge,  as  concomitant  multiorgan  failure,  electrolyte  derangements,  and  coagulopathy  further  complicate  the  clinical  picture.6-8  In  this  chapter,  we  will  review  the  universal  definition  of  myocardial  infarction  (MI)  and  the  related  patient  presentations,  risk  stratification  models,  complications,  and  management  strategies.