Acute coronary syndrome: Clinical assessment

Abstract

The term acute coronary syndrome (ACS) refers to any group of clinical symptoms compatible with acute myocardial ischemia and covers the spectrum of clinical conditions ranging from unstable angina (UA) to non ST-segment elevation (NSTE) myocardial infarction (MI) to ST-segment elevation (STE) MI. UA and NSTEMI are closely related conditions, in fact their pathophysiologic origins and clinical presentations are similar, but they differ in severity. The pathogenesis of ACS involves a complex interplay among the endothelium, the inflammatory cells, and the thrombogenicity of the blood. Autopsy studies have shown that plaque rupture causes approximately 75% of fatal MIs, whereas superficial endothelial erosion accounts for the remaining 20-25% [1-5].