Acute Coronary Syndrome

Acute coronary syndrome (ACS) encompasses ST-segment elevation myocardial infarction (STEMI), non-ST-segment elevation myocardial infarction (NSTEMI), and unstable angina, requiring rapid clinical assessment and intervention. Diagnosis relies on 12-lead EKGs and serial troponin measurements to guide treatment paths. STEMI management prioritizes immediate reperfusion via primary percutaneous coronary intervention (PCI) within 90 minutes or fibrinolysis if PCI is unavailable. Pharmacological management involves dual antiplatelet therapy, typically aspirin combined with a P2Y12 inhibitor like clopidogrel, prasugrel, or ticagrelor, alongside anticoagulation. While morphine and routine oxygen therapy were historically standard, current guidelines limit their use due to potential adverse effects on antiplatelet absorption and coronary blood flow. Long-term care focuses on secondary prevention through statins, beta-blockers, and ACE inhibitors, with dual antiplatelet therapy generally maintained for 12 months post-procedure to prevent recurrent thrombotic events.