Diagnosis and management of acute coronary syndromes

Acute coronary syndromes are a significant cause of morbidity and mortality in Australia. Outcomes are likely to be improved by rapid and accurate diagnosis, and early intervention. The development of high-sensitivity troponin assays has revealed previously unrecognised types of myocardial injury, for which conventional management guidelines for myocardial infarction may not confer similar benefits. The distinction between myocardial injury and myocardial infarction has therefore become increasingly important. Once the diagnosis of acute myocardial infarction has been made, individualised acute reperfusion strategies including percutaneous coronary intervention or fibrinolytic therapy should be considered. Secondary prevention strategies should be implemented before hospital discharge.