Talk:Acute coronary syndrome
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acute coronary syndrome should be discussed separately from angina
- The information is reaching the stage where unstable angina/ACS can be covered seperately from stable angina. JFW | T@lk 11:31, 19 March 2006 (UTC)
ST elevations in specific leads, a new left bundle branch block or a true posterior MI pattern : you need to explain what this means ; yes I know ECG patterns but in an intelligible way BillO'Slatter 13:23, 17 August 2006 (UTC)
This has been expanded
Merge with Myocardial infarction
We are discussing on Talk:Myocardial_infarction#Acute_Coronary_Syndromes the talk page for myocardial infarction] about possibly moving that article to this page. Please focus discussion on that page. Ksheka 01:19, 24 December 2006 (UTC)
ACS is commonly treated with aspirin, clopidogrel and either enoxaparin or an alternative LMWH. doi:10.1111/j.1572-0241.2007.01715.x looks into the bleed of digestive tract bleeding. 2.7% of 666 patients treated as ACS developed GI bleeding. The mortality in the cohort was 4.1%, mostly (3.6%) from cardiac causes. Only one (0.15%) died from a GI bleed. Risk for GI bleed increased in cardiogenic shock and previous PUD, and was significantly reduced if a PPI was co-prescribed. JFW | T@lk 07:42, 6 January 2008 (UTC)
When they banned smoking in public buildings in the UK, admissions for ACS dropped by 17%, mostly in non-smokers! http://content.nejm.org/cgi/content/short/359/5/482 JFW | T@lk 06:43, 31 July 2008 (UTC)
Acute coronary syndrome & Myocardial infarction
In wikipedia there is some occasional confusion between myocardial infarction (MI) and ST elevation myocardial infarction (STEMI). For instance, the article on Acute coronary syndromes (ACS) has a link to MI right uder the STEMI subsection of the treatment section. More importantly, there is occasional confusion between MI and ACS. Currently, ACS is the general term encompassing the following acute conditions: STEMI, non ST elevation MI (NSTEMI), and unstable angina. Moreover, NSTEMI and unstable angina fall under the umbrella of non ST elevation ACS: both American Heart Association/American College of Cardiology and European Society of Cardiology guidelines refer to Non-ST elevation ACS rather than NSTEMI. The major article is currently MI, in the sense that it contains most details on the ACS family of medical conditions. Accordingly, MI management is the only special article on the management of conditions of the ACS spectrum, and, indeed, is actually an article on management of ACS, as little distinction is made in current medical practice between management of NSTEMI and (confirmed) unstable angina. This perplexes what articles under each of the above titles must contain. I wonder:
- Should Myocardial infarction management be renamed Acute coronary syndrome management?
- Should, perhaps, two different articles be written on the management of STEMI and NST-ACS - which, despite significant overlap, have important differences (e.g. reperfusion)?
- Should, even, Myocardial infarction be renamed ST elevation MI, and all information that pertains both to STEMI and NSTEMI be directed to Acute coronary syndrome?
- My opinion is:
- Oppose, despite the great difficulties I have in improving the article on MI management. It would make the articles too technical for the general reader.
- Oppose. The term of the layman is "myocardial infarction". The article on ACS (which needs to be expanded) will just significantly overlap with the article on MI. (E.g., symptoms are basically the same).
(Please do not answer here, but on the talk page of Project Medicine.)
Rational Clinical Examination
- Amsterdam, EA, Wengern NK, Brindis RG, Casey DE Jr, Ganiats TG, Holmes DR Jr, Jaffe AS, Jneid H, Kelly RF, Kontos MC, Levine GN, Liebson PR, Mukherjee D, Peterson ED, Sabatine MS, Smalling RW, Zieman SJ (2014). "2014 AHA/ACC Guideline for the Management of Patients With Non-ST-Elevation Acute Coronary Syndromes: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines". Circulation. Published online September 23 2014. Retrieved 27 September 2014.
- The Task Force for the management of acute coronary syndromes (ACS) in patients presenting without persistent ST-segment elevation of the European Society of Cardiology (ESC) (2011). "ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation" (PDF). European heart Journal. 32: 2999–3054. doi:10.1093/eurheartj/ehr236.