Acute Coronary Syndromes (ACS)

Question 1

What is the definition of Acute Coronary Syndromes?

Answer 1

Any group of symptoms attributed to OBSTRUCTION of theCORONARY ARTERIES and includes:
• ST elevation myocardial infarction (STEMI)
• Non-ST elevation myocardial infarction (NSTEMI)
• Unstable angina

Question 2

What is the classic presentation of UA, STEMI and NSTEMI?

Answer 2

Unstable Angina: angina with ↑ frequency, unpredictability or at rest; chest pain <20mins
STEMI: Chest pain for >20 mins
NSTEMI: Chest pain for >20 mins

Question 3

What are the different findings of UA, STEMI and NSTEMI on ECG?

Answer 3

Unstable Angina: ST depression or T wave changes
STEMI: As for NSTEMI + ST elevation( >2mm in 2 consecutive chest lead or >1mm in 2 limb leads);?new LBBB
NSTEMI: ST depression or T wave inversion

Question 4

How common is ACS?

Answer 4

5 in 1000 in UK for STEMI