Acute Coronary Syndrome with 2025 ACC updates

Acute Coronary Syndrome (ACS) encompasses a spectrum of cardiac conditions—unstable angina, NSTEMI, and STEMI—defined by the severity of coronary artery blockage and resulting myocardial damage. Diagnosis relies on rapid 12-lead EKG interpretation and serial high-sensitivity troponin testing to identify heart muscle injury. For STEMI, primary percutaneous coronary intervention (PPCI) remains the gold standard, with a critical 90-minute target from first medical contact to device activation to minimize ischemic damage. Management strategies for NSTE-ACS are risk-stratified using tools like the GRACE score to determine the urgency of invasive intervention. Long-term recovery requires a multi-faceted approach, including high-intensity statin therapy, dual antiplatelet therapy, and mandatory referral to cardiac rehabilitation to reduce the risk of future cardiovascular events and improve overall survival outcomes.