Acute Coronary Syndrome February 15, 2001

Acute Coronary Syndrome February 15, 2001

Acute coronary syndrome includes unstable angina, non-Q-wave myocardial infarction, and Q-wave myocardial infarction. In Q-wave myocardial infarction, some patients exhibit ST-segment elevation, whereas in non-Q-wave myocardial infarction, ST-segment elevation varies in degree, with the typical upward arch being the most prominent.

① Acute coronary syndrome with ST-segment elevation: Ischemic chest pain lasting more than 30 seconds, with ST-segment elevation of at least 0.1 mV in two or more limb leads or in adjacent two precordial leads. Treatment options include direct PTCA or PTCA with stent placement. If there is a large amount of thrombus blocking the vessel and preventing successful PTCA, platelet membrane glycoprotein IIb/IIIa receptor antagonists should be administered first; however, no such drugs are currently available in China. If PTCA cannot be performed due to lack of resources, thrombolytic therapy is recommended.

② Acute coronary syndrome without ST-segment elevation: Chest pain accompanied by ST-segment depression of at least 0.05 mV, or T-wave inversion. Patients who have previously undergone PTCA for myocardial infarction and now present with obvious Q waves.

③ Unstable angina.