This document discusses ischemic heart disease and acute coronary syndrome (ACS). It defines ACS as a spectrum ranging from acute myocardial ischemia to myocardial infarction, caused by an imbalance between oxygen supply and demand in the heart. It can result from diminished blood flow due to a thrombus in a coronary artery. The document outlines desired outcomes of preventing ACS events and death, alleviating symptoms, and reducing complications and adverse effects of treatment. It also discusses risk stratification tools and short-term and long-term desired outcomes.
This document discusses ischemic heart disease and acute coronary syndrome (ACS). It defines ACS as a spectrum ranging from acute myocardial ischemia to myocardial infarction, caused by an imbalance between oxygen supply and demand in the heart. It can result from diminished blood flow due to a thrombus in a coronary artery. The document outlines desired outcomes of preventing ACS events and death, alleviating symptoms, and reducing complications and adverse effects of treatment. It also discusses risk stratification tools and short-term and long-term desired outcomes.
This document discusses ischemic heart disease and acute coronary syndrome (ACS). It defines ACS as a spectrum ranging from acute myocardial ischemia to myocardial infarction, caused by an imbalance between oxygen supply and demand in the heart. It can result from diminished blood flow due to a thrombus in a coronary artery. The document outlines desired outcomes of preventing ACS events and death, alleviating symptoms, and reducing complications and adverse effects of treatment. It also discusses risk stratification tools and short-term and long-term desired outcomes.
Desired Outcomes • Prevent acute coronary syndrome and death • Alleviate acute symptoms of myocardial ischemia • Prevent recurrent symptoms of myocardial ischemia • Prevent progression of the disease • Reduce complications of IHD • Avoid or minimize adverse treatment effects Acute Coronary Syndrome ACS Spectrum • From acute myocardial ischemia to MI resulting from an imbalance between myocardial ACS oxygen demand and supply
• results primarily from
STEMI NSTE-ACS diminished myocardial blood flow secondary to an occlusive or partially occlusive coronary NSTEMI UA artery thrombus Troponin Risk Stratification • GRACE • http://www.outcomes-umassmed.org/GRACE/acs_risk/acs_risk_content.html • TIMI • https://www.mdcalc.com/timi-risk-score-ua-nstemi • ACS NSQIP • https://riskcalculator.facs.org/RiskCalculator/PatientInfo.jsp • ACC/AHA • http://www.cvriskcalculator.com/ Desired Outcomes • Short-term: • Long-term: • early restoration of blood flow to the • control of CV risk factors, infarct-related artery to prevent • prevention of additional CV events, infarct expansion (in the case of MI) including reinfarction, stroke, and HF, or prevent complete occlusion and MI and (in UA); • improvement in quality of life • prevention of death and other MI complications; • prevention of coronary artery reocclusion; • relief of ischemic chest discomfort; and • resolution of ST segment and T-wave changes on the ECG