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Strategies in Acute Coronary Syndrome

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Textbook of Catheter-Based Cardiovascular Interventions

Abstract

Acute coronary syndromes include a wide spectrum of clinical coronary disease states, from unstable angina with no observable electrocardiogram changes to ST-segment elevation myocardial infarction. If not recognized and treated immediately, they may prove fatal in some cases. Percutaneous coronary intervention has emerged as a primary treatment for the majority of these patients, often on an urgent or emergency basis. Most of the interventions are ad hoc immediately following a diagnostic coronary angiogram. Understanding the details of these procedures is very important. Furthermore, knowledge of ancillary pharmacotherapy, anticoagulants, antiplatelet agents, and thrombolytics is vital in managing these patients. At times, these patients present with cardiac arrest or cardiogenic shock, which complicates management further. Intra-aortic balloon pump and Impella® devices can be used for hemodynamic support in these situations. In this chapter, we discuss the approaches for managing acute coronary syndromes, with emphasis on revascularization strategies and essential ancillary topics associated with revascularization. We also discuss the management of patients presenting with cardiogenic shock and after cardiac arrest.

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Dhoble, A., Anderson, H.V. (2018). Strategies in Acute Coronary Syndrome. In: Lanzer, P. (eds) Textbook of Catheter-Based Cardiovascular Interventions. Springer, Cham. https://doi.org/10.1007/978-3-319-55994-0_55

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