Nguyen Van Si

Department of Internal Medicine

ACUTE CORONARY SYNDROME

CARDIOVASCULAR RISK FACTORS

CORONARY HEART DISEASE

STABLE ANGINA• Retrosternal chest discomfort

• Pressure, heaviness, squeezing, burning, or choking sensation

• Radiation of pain are arms, shoulders, and neck

• Precipitated by exertion, exposure to cold, or emotional stress

• Relieved by rest or nitroglycerin

ANGINA PECTORIS

UNSTABLE ANGINAAt least one of the following

• Occurs at rest or minimal exertion and usually lasts >20 minutes

• Being severe and described as frank pain, and of new onset (within 1 month)

• Crescendo pattern (more severe, prolonged, or increased frequency than previously)

ACUTE CORONARY SYNDROME

ECG

CARDIAC MARKERS

ACUTE CORONARY SYNDROME• ST elevation myocardial infarction

• Non-ST elevation myocardial infarction

• Unstable angina

ELECTROCARDIOGRAPHY

ELECTROCARDIOGRAPHY

CARDIAC BIOMARKERS

ST ELEVATION MYOCARDIAL INFARCTIONTreatment

• Aspirin

• Clopidogrel

• Oxygen

• Nitrate

• Morphine sulfate

TREATMENT

Routine Measures Antiplatelet

• For plaque stabilization

• Regardless of lipid level

• Unfractionated heparin

• Low molecular weight heparin

TREATMENT

Anticoagulant Statin

• ACE inhibitor should be administered within 24 hrs.

• ARB if ACE inhibitor is intolerant

• Beta-blocker should be administered promptly

TREATMENT

Beta Blocker Inhibition of RAAS

TREATMENT

TREATMENT

THANK YOU FOR YOUR ATTENTION