Acute coronary syndrome
Contents:
see also:
- Coronary heart disease
- Stenocardia
- Unstable stenocardia
- Stable stenocardia
- To show all list
Description:
The acute coronary syndrome includes unstable stenocardia and a myocardial infarction without Q tooth.
Symptoms of the Acute coronary syndrome:
The acute coronary syndrome can be expressed by the following clinical forms:
1. For the first time the arisen angina of exertion is characterized by emergence of attacks of stenocardia for the first time in life (duration of the anamnesis of anginous attacks within 1 month), especially, if they accrue on frequency, duration, intensity and at the same time the effect of nitroglycerine decreases. The debut of an ischemic heart disease can have several options: the first attacks of coronary pain can arise at an exercise stress and remain rather stereotypic; in other cases stenocardia attacks quickly accrue on the frequency and intensity, being combined with pains at rest; the third option is characterized by emergence of spontaneous attacks of coronary pain, lasting 5-15 minutes; also long anginous attacks are not excluded.
2. The progressing angina of exertion.
3. Alternative stenocardia (Printsmetal's stenocardia).
4. Early postinfarction unstable stenocardia.
Reasons of the Acute coronary syndrome:
The reasons of the progressing current of an acute coronary syndrome are caused by changes from an atherosclerotic plaque, an endothelium and thrombocytes. The most important mechanism of development of acute coronary insufficiency consider a rupture of an atherosclerotic plaque in a coronary artery with the subsequent formation of blood clot and strengthening of a tendency to a coronary spasm.
Treatment of the Acute coronary syndrome:
All patients with an acute coronary syndrome are subject to urgent hospitalization in chambers of an intensive care. In parallel with treatment carry out record ECG in dynamics, the general blood test, definition of cardiospecific enzymes, whenever possible EhoKG, a myocardium stsintigrafiya, the round-the-clock clinical and monitor observation.
Tactical problems of therapy of an acute coronary syndrome:
* elimination of pain;
* prevention of an acute myocardial infarction;
* prevention of sudden coronary death.
Strategic problem of therapy of an acute coronary syndrome: stabilization of a coronary blood-groove and elimination of morphological substrate of a disease (in particular, the damaged atherosclerotic plaque).
