Acute coronary syndromes electrocardiogram

Patients with ischemic chest discomfort and suspected acute coronary syndrome are risk-stratified based upon a 12-lead electrocardiogram, past medical history, and results of the creatine kinase myocardial band and troponin tests. The diagnosis... 

Acute coronary syndromes is a term that includes all clinical syndromes compatible with acute myocardial ischemia resulting from an imbalance between myocardial oxygen demand and supply.3 In contrast to stable angina, an ACS results primarily from diminished myocardial blood flow secondary to an occlusive or partially occlusive coronary artery thrombus. Acute coronary syndromes are classified according to electrocardiogram (ECG) changes into STE ACS (STE MI) or NSTE ACS (NSTE MI and unstable angina) (Fig. 5-1). An STE MI, formerly... 

Acute coronary syndromes Ischemic chest discomfort at rest, most often accompanied by ST-segment elevation, ST-segment depression, or T-wave inversion on the 12-lead electrocardiogram. Furthermore, it is caused by plaque rupture and partial or complete occlusion of the coronary artery by thrombus. Acute coronary syndromes include myocardial infarction and unstable angina. Former terms used to describe types of acute coronary syndromes include Q-wave myocardial infarction, non-Q-wave myocardial infarction, and unstable angina. 

Abbreviations ACS. acute coronary syndrome AECG. ambulatory electrocardiogram FLORIDA, fluvastatin on risk diminishment after acute myocardial infarction Ml. myocardial infarction MIRACL, myocardial ischemia reduction with aggressive cholesterol lowering nfMI. nonfatal myocardial infarction PACT, pravastatin in acute coronary treatment PROVE-IT TIMI 22. pravastatin or atoivastatin evaluation and infection therapy—thrombolysis in myocardial infarction 22 UAP, unstable anginapectoris. 

Birnbaum Y, Atar S. Electrocardiogram risk stratification of non ST elevation acute coronary syndrome. J Electrocardiol 2006 39 558. 

The electrocardiogram (ECG), which was discovered more than 100 years ago and has just celebrated its first century, appears to be more alive than ever. Until recently its utility was especially important for identifying different ECG morphological abnormalities, including arrhythmias, blocks at all levels, pre-excitation, acute coronary syndromes, as well as Q-wave acute myocardial infarction, for which ECG was the gold-standard diagnostic technique. 

FIGURE 16-1. Evaluation oftheacutecoronary syndrome patient. ACS = acute coronary syndrome CAD = coronary artery disease CK = creatine kinase ECG = electrocardiogram PCI = percutaneous coronary intervention Positive = above the Ml decision limit Negative = below the Ml decision limit. 

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