< CZ:Featured articleRevision as of 00:44, 7 September 2012 by imported>Chunbum Park
In medicine and cardiology, acute coronary syndrome (ACS) is a collection of signs and symptoms due to inadequate oxygenation of the heart muscle, the myocardium, usually due to coronary artery disease.[1] ACS includes myocardial infarction ("heart attack") and angina.
Pain relief and proper oxygenation is the core of ACS treatment. When the root causie is angina, the temporary cause of ischemia should be reversed. For myocardial infarction, more vigorous interventions are appropriate if they can prevent damage to myocardium.
Etiology/causes
Atheroclerotic obstruction
ACS is usually caused by obstruction in an epicardial coronary artery.[2] The obstruction may be due to a thrombus at the site of a ruptured atherosclerotic plaque.[3]
Rupture seems more likely to occur during the morning hours.[4] Rupture may be precipited by inflammation from non-cardiac infections.[5] Rupture may be triggered by vigorous exercise among individuals who do not ordinarily do vigorous exercise.[6]
Coronary vasospasm
Approximately 15% of NSTEMI and 2% of STEMI patients have no obstruction of coronary vessels and in about half of these patients, spasm can be induced of a coronary artery.[2]
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- ↑ Anonymous (2024), Featured article/Current (English). Medical Subject Headings. U.S. National Library of Medicine.
- ↑ 2.0 2.1 Ong P, Athanasiadis A, Hill S, Vogelsberg H, Voehringer M, Sechtem U (August 2008). "Coronary artery spasm as a frequent cause of acute coronary syndrome: The CASPAR (Coronary Artery Spasm in Patients With Acute Coronary Syndrome) Study". J. Am. Coll. Cardiol. 52 (7): 523–7. DOI:10.1016/j.jacc.2008.04.050. PMID 18687244. Research Blogging.
- ↑ Mizuno K, Satomura K, Miyamoto A, et al (January 1992). "Angioscopic evaluation of coronary-artery thrombi in acute coronary syndromes". N. Engl. J. Med. 326 (5): 287–91. PMID 1728732. [e]
- ↑ Muller JE, Stone PH, Turi ZG, et al (November 1985). "Circadian variation in the frequency of onset of acute myocardial infarction". N. Engl. J. Med. 313 (21): 1315–22. PMID 2865677. [e]
- ↑ Harskamp RE, van Ginkel MW (2008). "Acute respiratory tract infections: a potential trigger for the acute coronary syndrome". Ann. Med. 40 (2): 121–8. DOI:10.1080/07853890701753672. PMID 18293142. Research Blogging.
- ↑ Siscovick DS, Weiss NS, Fletcher RH, Lasky T (October 1984). "The incidence of primary cardiac arrest during vigorous exercise". N. Engl. J. Med. 311 (14): 874–7. PMID 6472399. [e]
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