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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¡@ Non-Q MI and Unstable Angina
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¡@ Caused by less obstructive thrombus with less robust fibrin and more platelet
¡@ May cause T wave inversion or ST depression depending on extent of occlusion

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Non-Q MI
Unstable Angina
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More prolonged episode of plaque rupture with persistent impairment of antegrade flow but with subsequent restoration of some antegrade flow
Less extensive myocardial necrosis, often subendocardial with no subsequent pathological Q wave on ECGs
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Relieve of vasospasm or spontaneous lysis of thrombus with restoration of antegrade flow (filling deficit in angiogram)
Less than 20 minutes of flow obstruction
No myocardial necrosis or persistent ECG changes
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