Acute coronary syndromes without ST segment elevation

doi:10.1136/bmj.39220.618646.AE

BMJ 2007;334:1265-1269 (16 June), doi:10.1136/bmj.39220.618646.AE

Clinical Review

Acute coronary syndromes without ST segment elevation

Ron J G Peters, clinical cardiologist¹, Shamir Mehta, clinical cardiologist², Salim Yusuf, clinical cardiologist²

¹ Department of Cardiology, Academic Medical Center, PO Box 22660, Amsterdam 1100, Netherlands, ² Department of Medicine, McMaster University and Population Health Research Institute, Hamilton Health Sciences, Hamilton, ON L8L 2X2, Canada

Correspondence to: R J G Peters r.j.peters@amc.uva.nl

The first 150 words of the full text of this article appear below.

In the United Kingdom, about 114 000 patients with acute coronarysyndromes are admitted to hospital each year.¹ More than 5.5million patients present to a US emergency department with chestpain and other symptoms related to acute coronary syndrome eachyear.² Acute coronary syndrome is seen in people of all ages,races, and socioeconomic backgrounds.

The patient's history is the most importantinitial diagnostic tool

Patients suspected of having an acutecoronary syndrome need to be admitted and evaluated by electrocardiographyand measurement of cardiac "markers"

Acute coronary syndromesare classified on the basis of the presence or absence of STsegment elevation on the admission electrocardiogram

All patientswith acute coronary syndromes need intensive medical treatment,including combinations of antithrombotic drugs

In high riskpatients, coronary angiography is indicated, with the aim ofrevascularisation if they have suitable coronary anatomy

Elevationof cardiac markers determines whether a discharge . . . [Full text of this article]

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