Read e-book online Acute Coronary Syndrome: Multidisciplinary and Pathway-Based PDF

By Mun K. Hong, Eyal Herzog

ISBN-10: 1846288681

ISBN-13: 9781846288685

ISBN-10: 184628869X

ISBN-13: 9781846288692

Edited via top cardiologists from St. Luke’s-Roosevelt health facility middle in ny, this ebook bargains functional algorithms for acquiring fast, exact diagnoses and offering optimum remedy for sufferers with acute coronary syndrome (ACS). You’ll become aware of the professionals and cons and the entire concerns that pass into settling on the simplest interventional and non-invasive strategies for treating diversified ACS stipulations.

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Sample text

The Concept of Vulnerable Plaque In early 1980s, Falk demonstrated that ruptured atherosclerotic plaques were responsible for 40 of 51 recent coronary artery thrombi and 63 larger intimal hemorrhages [17]. He also demonstrated plaque fragments deeply buried in the thrombus overlying the athermanous plaque. In the late 1980s, Muller et al. proposed that the initial step in acute coronary thrombosis is the development 4. Epidemiology and Pathophysiology of ACS 27 Inflammation 1. Matrix breakdown 2.

Potential mechanisms of this type of angina include endothelial injury and hypercontractility of smooth muscle. Transition from Stable Plaque to Vulnerable Plaque Plaque rupture and endothelial erosion with subsequent thrombus formation are the most frequent causes of ACS [38]. However, intravascular ultrasound (IVUS) study conducted by Rioufol et al. [39] in patients with ACS revealed a high incidence of multiple plaque ruptures in these patients. Likewise, IVUS study by Maehara et al. [40] showed that plaque ruptures occur not only in ACS patients but also in patients with stable angina or asymptomatic ischemia.

4. New or worsening heart failure symptoms; Malignant ventricular arrhythmias; Hemodynamic instability; or Recent (<6 months) PCI or CABG. 2. The PAIN Pathway for the Management of ACS 17 If there is evidence of any of these high-risk features, we recommend to transfer the patient for cardiac catheterization within 12 to 48 hours and for revascularization by PCI or CABG if necessary. Patients with no evidence of high-risk features should be referred for cardiac imaging stress testing (stress echocardiography or stress nuclear test).

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Acute Coronary Syndrome: Multidisciplinary and Pathway-Based Approach by Mun K. Hong, Eyal Herzog


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