RT Journal Article
SR Electronic
T1 Diagnosis and Management of Acute Coronary Syndrome: An Evidence-Based Update
JF The Journal of the American Board of Family
                Medicine
JO J Am Board Fam Med
FD American Board of Family Medicine
SP 283
OP 293
DO 10.3122/jabfm.2015.02.140189
VO 28
IS 2
A1 Jennifer N. Smith
A1 Jenna M. Negrelli
A1 Megha B. Manek
A1 Emily M. Hawes
A1 Anthony J. Viera
YR 2015
UL http://www.jabfm.org/content/28/2/283.abstract
AB Acute coronary syndrome (ACS) describes the range of myocardial ischemic states that includes unstable angina, non-ST elevated myocardial infarction (MI), or ST-elevated MI. ACS is associated with substantial morbidity and mortality and places a large financial burden on the health care system. The diagnosis of ACS begins with a thorough clinical assessment of a patient's presenting symptoms, electrocardiogram, and cardiac troponin levels as well as a review of past medical history. Early risk stratification can assist clinicians in determining whether an early invasive management strategy or an initial conservative strategy should be pursued and can help determine appropriate pharmacologic therapies. Key components in the management of ACS include coronary revascularization when indicated; prompt initiation of dual antiplatelet therapy and anticoagulation; and consideration of adjuvant agents including β blockers, inhibitors of the renin angiotensin system, and HmG–coenzyme A reductase inhibitors. It is essential for clinicians to take an individualized approach to treatment and consider long-term safety and efficacy when managing patients with a history of ACS after hospital discharge.