By Jayanthi N. Koneru MD, Lance W. Weathers MD, Michael Lesch MD (auth.), Mun K. Hong MD, Eyal Herzog MD, FACC (eds.)
Acute coronary syndrome (ACS) impacts thousands of sufferers every year and calls for speedy analysis and remedy. severely, given the getting older worldwide inhabitants, ACS is decided to turn into a fair better clinical challenge, not just for the emergency room and cardiology physicians, yet for all experts treating the older inhabitants prone to ACS. Advances within the remedy of ACS can justifiably be certainly one of the nice achievements of recent drugs. The evolution of therapy techniques represents a notable success, yet there's an pressing have to teach these experts treating the high-risk inhabitants. This functional algorithm-based guide addresses the prognosis and therapy of those sufferers and is designed for the clinical group of workers all for the triage and administration of ACS patients.
Acute Coronary Syndrome: Multidisciplinary and Pathway-Based Approach bargains scientific assistance to all trainees and non-medical experts and offers a framework for more matured employees to regulate ACS sufferers successfully. The authors have compiled a wealth of clinically worthwhile instruments and data drawn from their adventure at St. Luke’s-Roosevelt medical institution middle in ny, making this ebook a accomplished evidence-based source that permits readers to extend their wisdom and permits swift prognosis and therapy of sufferers with ACS.
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Additional resources for Acute Coronary Syndrome: Multidisciplinary and Pathway-Based Approach
Josephson, and Eyal Herzog Coronary artery disease is the leading cause of death in the United States. Approximately 5 million patients present to the emergency department (ED) for chest pain-related complaints every year . In addition, a signiﬁcant number of patients may present to the ED with atypical symptoms. Early diagnosis and management of acute coronary syndrome (ACS) may lead to a signiﬁcant reduction in associated morbidity and mortality. ED physicians play an important role in the rapid diagnosis and management of patients with suspected ACS.
Pathophysiology Atherosclerosis used to be considered a bland lipid storage disease. According to the conventional theory, fatty streaks (earliest stage of atheroma) evolved into complicated plaques through multiplication of smooth muscle cells within the plaque, which laid down an abundant extracellular matrix. With coronary plaque progression, the arterial lumen narrowed until it impeded ﬂow and caused ACS . However, new advances in vascular biology have demonstrated that atherosclerosis is a systemic immune-mediated inﬂammatory disease affecting medium-sized and large arteries where various types of cells such as endothelial cells, leukocytes, and intimal smooth muscle cells are involved in its development .
Compared with the Advanced Risk patients, the Immediate Risk patients do not have evidence of dynamic ST changes on the electrocardiogram or evidence of positive cardiac markers (see Chapter 8). These patients should be admitted to the telemetry ﬂoor and be given aspirin, heparin, and beta-blocker (Fig. 9). We recommend a minimum telemetry stay of 12 to 24 hours. If during this period of time there is evidence of dynamic ST changes on the electrocardiogram or evidence for positive cardiac markers, the patients should be treated as if they had been stratiﬁed to the Advanced Risk group.
Acute Coronary Syndrome: Multidisciplinary and Pathway-Based Approach by Jayanthi N. Koneru MD, Lance W. Weathers MD, Michael Lesch MD (auth.), Mun K. Hong MD, Eyal Herzog MD, FACC (eds.)