Acute Coronary Syndrome - Ischemic Heart Disease

Acute coronary syndrome (ACS, formerly called ischemic heart disease) refers to a large spectrum of clinical conditions, including unstable angina, myocardial injury, and myocardial infarction (MI). ACS is caused by a sudden onset of cardiac tissue ischemia secondary to impaired blood flow. The precipitating event is blockage in the coronary arteries or a mismatch between the demand and supply of blood to cardiac tissue. The tissue ischemia that results can cause substernal chest pressure; radiation of pain to the left arm, shoulder, or jaw; shortness of breath; sweating; nausea; and changes on an electrocardiogram (ECG). Patients who present with symptoms of ACS, including chest pain, should be immediately evaluated. Recommended evaluation includes a clinical assessment, electrocardiography, and laboratory testing.  Laboratory testing for ACS includes diagnostic testing for markers of damage to heart tissue (cardiac troponins [cTns] I and T [cTnI and cTnT]), as well as prognostic testing (eg, B-type natriuretic peptide).

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Content Review: 
April 2019

Last Update: November 2019