Key result
ACS diagnosis requires an ECG within 10 minutes and serial hs-cTn to guide timely reperfusion.
Why the study?
Acute Coronary Syndrome is a major cause of cardiovascular morbidity and mortality worldwide, motivating a synthesis of evidence on its epidemiology, risk factors, pathophysiology, classification, diagnosis, and initial management.
Answers are grounded in this paper and cite their sources.
This narrative review synthesizes current international (ESC 2023) and Indonesian (PERKI 2024) guideline recommendations for the rapid triage, diagnosis, and initial emergency management of acute coronary syndrome.
Acute Coronary Syndrome (ACS) is a major cause of cardiovascular morbidity and mortality worldwide. This review aims to summarize its epidemiology, risk factors, pathophysiology, classification, diagnosis, and initial management. A literature review was conducted to synthesize evidence on ACS presentation, electrocardiographic (ECG) findings, cardiac biomarkers, and emergency management. The databases, search period, keywords, and literature selection criteria should be specified according to the actual search process. ACS comprises ST-Elevation Myocardial Infarction (STEMI), Non-ST-Elevation Myocardial Infarction (NSTEMI), and Unstable Angina (UA). Its primary mechanism involves acute coronary atherothrombosis associated with plaque rupture or erosion and subsequent thrombus formation. Diagnosis integrates clinical assessment, a 12-lead ECG within 10 minutes of first medical contact, and serial high-sensitivity cardiac troponin (hs-cTn) measurements when indicated. Initial management includes hemodynamic stabilization, antiplatelet therapy, oxygen for hypoxemia, symptom relief, and timely reperfusion or revascularization based on clinical presentation and risk. Early diagnosis and systematic, evidence-based management are essential to reduce complications and improve outcomes in patients with ACS.
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Nurhalizah et al. (2026) conducted a review in Acute Coronary Syndrome (STEMI, NSTEMI, and Unstable Angina). Initial management and diagnostic triage for Acute Coronary Syndrome (12-lead ECG within 10 minutes, serial hs-cTn, antiplatelet therapy, and reperfusion) was evaluated. Acute coronary syndrome diagnosis requires a 12-lead ECG within 10 minutes of first medical contact and serial hs-cTn testing to guide timely reperfusion and antiplatelet therapy.
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