By Mun K. Hong, Eyal Herzog
Edited by means of top cardiologists from St. Luke’s-Roosevelt clinic heart in long island, this e-book deals functional algorithms for acquiring speedy, exact diagnoses and delivering optimum therapy for sufferers with acute coronary syndrome (ACS). You’ll observe the professionals and cons and the entire concerns that cross into picking out the simplest interventional and non-invasive concepts for treating various ACS stipulations.
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Extra info for Acute Coronary Syndrome: Multidisciplinary and Pathway-Based Approach
Vulnerable atherosclerotic plaque: clinical implications. ) dependent vasoconstriction. However, in Prinzmetal angina, the site of transient, abrupt spasm is often adjacent to atheromatous plaque. Potential mechanisms of this type of angina include endothelial injury and hypercontractility of smooth muscle. Transition from Stable Plaque to Vulnerable Plaque Plaque rupture and endothelial erosion with subsequent thrombus formation are the most frequent causes of ACS . However, intravascular ultrasound (IVUS) study conducted by Rioufol et al.
1 in black women . 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 .
History suggestive of recent major bleed, intracranial tumor, major surgery within the previous 2 weeks, or hemorrhagic stroke and supportive ﬁnding of fresh gastrointestinal bleeding may be a contraindication for such directed therapy. A rectal exam should be done to test for hemoccult as well, as part of the exam to help identify bleeding risks. Electrocardiogram An initial electrocardiogram (ECG) should be obtained on all patients with chest pain within 10 minutes of presentation to the ED (see Chapter 2, Fig.
Acute Coronary Syndrome: Multidisciplinary and Pathway-Based Approach by Mun K. Hong, Eyal Herzog