Premium
Managing antiplatelet therapy in the ACS patient: Straight from the emergency department to you
Author(s) -
Hoekstra James W.
Publication year - 2008
Publication title -
journal of hospital medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.128
H-Index - 65
eISSN - 1553-5606
pISSN - 1553-5592
DOI - 10.1002/jhm.320
Subject(s) - medicine , emergency department , hospital medicine , medical emergency , emergency medicine , medline , intensive care medicine , nursing , political science , law
Atherothrombosis triggered by plaque rupture reduces arterial blood flow, leading to myocardial ischemia and/or necrosis, in which the extent of occlusion relates to the clinical presentations of acute coronary syndrome (ACS): unstable angina (UA), non-STsegment and ST-segment elevated myocardial infarction (NSTEMI and STEMI, respectively). Although UA and NSTEMI may be indistinguishable at the time of presentation, NSTEMI is defined by myocardial necrosis and is differentiated by release of cardiac enzymes. In UA, the myocardial ischemia is reversible, without necrosis. Typically, STEMI results from the total occlusion of a large epicardial infarct-related artery and is diagnosed by electrocardiography (ECG) and the release of cardiac enzymes. Strategies employed by emergency physicians and hospitalists to treat the spectrum of symptoms caused by ACS include pharmacotherapy and revascularization procedures. Coordination of care between these 2 groups of physicians, and appropriate handoff of patients from the ED to hospitalists, utilizing guideline-based care pathways and treatment protocols, will ensure maximization of outcomes in patients with ACS.