Acute Coronary Syndromes: Diagnosis and Management, Part II
AUTOR(ES)
Kumar, Amit
FONTE
Mayo Foundation for Medical Education and Research
RESUMO
At the most severe end of the spectrum of acute coronary syndromes is ST-segment elevation myocardial infarction (STEMI), which usually occurs when a fibrin-rich thrombus completely occludes an epicardial coronary artery. The diagnosis of STEMI is based on clinical characteristics and persistent ST-segment elevation as demonstrated by 12-lead electrocardiography. Patients with STEMI should undergo rapid assessment for reperfusion therapy, and a reperfusion strategy should be implemented promptly after the patient's contact with the health care system. Two methods are currently available for establishing timely coronary reperfusion: primary percutaneous coronary intervention and fibrinolytic therapy. Percutaneous coronary intervention is the preferred method but is not always available. Antiplatelet agents and anticoagulants are critical adjuncts to reperfusion. This article summarizes the current evidence-based guidelines for the diagnosis and management of STEMI. This summary is followed by a brief discussion of the role of noninvasive stress testing in the assessment of patients with acute coronary syndrome and their selection for coronary revascularization.
ACESSO AO ARTIGO
http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=2770915Documentos Relacionados
- New advances in the management of acute coronary syndromes: 4. Low-molecular-weight heparins
- New advances in the management of acute coronary syndromes: 1. Matching treatment to risk
- Discharge rates for suspected acute coronary syndromes: Authors' reply
- New advances in the management of acute coronary syndromes: 3. The role of catheter-based procedures
- New advances in the management of acute coronary syndromes: 2. Fibrinolytic therapy for acute ST-segment elevation myocardial infarction
