Acute coronary syndromes are managed by stratifying patients into risk categories using clinical and ECG criteria, with high-risk patients receiving combined medical and invasive therapy.
This review outlines the risk stratification and management protocols for acute coronary syndromes, highlighting the role of combined medical and invasive therapies for high-risk patients.
Patients with acute coronary syndromes may be divided into those who have had a myocardial infarction with ST elevation on their ECG, and those without ST elevation. The latter group can be further classified as having a high, intermediate or low risk of death or having a myocardial infarction. These risks are stratified by newly determined clinical and ECG criteria, and specific serum markers of myocardial injury. There are protocols for the evaluation of chest pain. Structured protocols are used to assess intermediate risk patients in order to reduce the incidence of 'missed infarcts' and to facilitate early discharge where appropriate. Patients have a high risk if they have pain at rest, ST depression and elevated serum troponin. They are actively managed with combined medical and invasive therapy. Low molecular weight heparin and IIb/IIIa platelet receptor blockers have become an important part of management.
Con Aroney (Fri,) conducted a review in Acute coronary syndromes. Management protocols (medical and invasive therapy, LMWH, IIb/IIIa blockers) was evaluated. Acute coronary syndromes are managed by stratifying patients into risk categories using clinical and ECG criteria, with high-risk patients receiving combined medical and invasive therapy.