Acute coronary syndromes

Acute coronary syndromes are defined as unstable angina, non-Q-wave myocardial infarction, and Q-wave myocardial infarction. These entities remain among the commonest life-threatening illnesses in industrialized nations. Prompt recognition of a patient with an acute coronary syndrome is important since appropriate therapy can markedly improve the patient's prognosis. Reperfusion strategies for patients with Q-wave myocardial infarction, and anticoagulation and antiplatelet therapy for patients with unstable angina or non-Q-wave myocardial infarction are examples of such potentially life-saving interventions. A number of adjunctive pharmacological interventions are also beneficial following reperfusion therapy in patients with Q-wave myocardial infarction. Management of complications following Q-wave myocardial infarction has improved markedly in recent years. This is particularly the case with postinfarction ischemia or heart failure. Persistent arrhythmias, and in particular ventricular arrhythmias, remain a troubling challenge for the clinician. Reperfusion therapy markedly reduces the incidence of complications following Q-wave myocardial infarction.