Acute Coronary Syndromes

Update Management on ACS
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ACS

Overview

Plaques

Properties
Role of acute changes
Erosion & Disruption
Types
Fissuring & Rupture

MI

Different forms of MI
Q Wave MI
Non-Q MI & Unstable Angina
Treatment of ACS
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Ischemic Heart Disease

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Heart diseases remain the second leading cause of death in Hong Kong

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Overall fatality rate is around 30% with > 50% died within one hour, mainly from ventricular fibrillation

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Acute Coronary Syndromes

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   - Plaque rupture causes release and accumulation of thrombogenic substances 
   - Lumen occlusion by a combination of fibrin, platelet aggregates and red blood cells 
   - Extent of lumen occlusion determines the acute coronary syndrome produced

   - A spectrum of clinical entities that composed of

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unstable angina
non-Q myocardial infarction

Q wave myocardial infarction

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Pathology of Acute Coronary Syndromes

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Almost all result from coronary atherosclerosis, generally with superimposed coronary thrombosis

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AMI without Atherosclerosis

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