Ver el código de «Acute coronary syndrome (main)»

''For risk stratification see  [[ACS - Risk Stratification]]''
==Background==
*Abbreviation: ACS
*Refers to a spectrum of conditions compatible with acute myocardial ischemia and/or infarction that are usually due to an abrupt reduction in coronary blood flow. 

{{Clinical ACS Categories}}
{{MI Types by Causation}}

==Clinical Features==
{{Clinical features ACS}}

==Differential Diagnosis==
{{Chest Pain DDX}}

{{Elevated troponin DDX}}

==Evaluation==
===Workup===
*[[ECG (Diagnosis)]]
**[[ECG]] is normal in 8% of all confirmed MI's
**In [[LBBB]] see [[Sgarbossa's Criteria]]
*[[Cardiac Enzymes]]

===Evaluation===
*HEART Pathway: https://www.mdcalc.com/heart-pathway-early-discharge-acute-chest-pain 
*[[ACS - Risk Stratification]]

{{ACS anatomical correlation}}

==Management==
''Intensity of treatment should be based on ACS likelihood'' 

*[[ST-Elevation Myocardial Infarction (STEMI)]]
*[[Non ST-Elevation Myocardial Infarction (NSTEMI)]]
*[[Unstable Angina]]

==Disposition==
*Admit
**Ischemic ECG changes
**Pacemakers
**LBBB
**Positive troponins
**Abnormal vital signs
*ACC/AHA rec need for provocative testing withing 72 hrs, consider admitting
*For low risk (HEART) pts, may be better off discharge home with follow up<ref> Weinstock MB, Weingart S, Orth F, VanFossen D, Kaide C, Anderson J, Newman DH. Risk for Clinically Relevant Adverse Cardiac Events in Patients With Chest Pain at Hospital Admission. JAMA Intern Med. 2015 Jul;175(7):1207-12. </ref>
**Risk of MACE after neg ED work up 1/2422 vs Risk of preventable adverse event in hospital is 1/164

===Prognosis===
*[[ACS - Stress Testing]]

== Calculators ==
{{HEART_Score_Calculator}}

{{TIMI_NSTEMI_Calculator}}

==External Links==
*[https://www.mdcalc.com/heart-pathway-early-discharge-acute-chest-pain  MDCalc - HEART Pathway]
*[http://www.mdcalc.com/framingham-coronary-heart-disease-risk-score/ MDCalc - Framingham Coronary Heart Disease Risk Score]
*[http://www.mdcalc.com/sgarbossa-criteria-for-mi-in-left-bundle-branch-block/ MDCalc - Sgarbossa’s Criteria for MI in Left Bundle Branch Block]
*[http://www.mdcalc.com/timi-risk-score-for-uanstemi/ MDCalc - TIMI Risk Score for UA/NSTEMI]
*[http://www.heart.org/HEARTORG/ Heart Association]

==See Also==
*[[ACS - Risk Stratification]]
*[[ACS - Anatomical Correlation]]
*[[ACS - Stress Testing]]
*[[ST-segment elevation myocardial infarction]]
*[[Non-ST-elevation myocardial infarction]]
*[[Unstable angina]]
*[[STEMI equivalents]]
*[[Myocardial infarction complications]]

==References==
<references/>

[[Category:Cardiology]]