#451 Acute Coronary Syndrome with Dr. Sanjeev Francis - Part 2

Acute Coronary Syndrome (ACS) management requires a nuanced approach to diagnostics and medical therapy. A stone-cold normal coronary CT scan offers a warranty period of approximately two years in the emergency department setting, whereas other stress testing modalities provide only about one year of durability. For NSTEMI patients, risk stratification using the GRACE score guides the timing of coronary angiography, with early intervention prioritized for high-risk cases. Medical management centers on loading doses of aspirin, high-intensity statins, and judicious use of anticoagulation, while moving away from routine upfront P2Y12 inhibitor administration. Myocardial injury, such as type 2 NSTEMI, necessitates addressing the underlying trigger, like pneumonia or hypoxia, while acknowledging the associated long-term prognostic risks. Cardiac rehabilitation remains a critical, underutilized intervention for all ACS patients, offering significant mortality benefits through structured exercise and lifestyle modification.