Acute Coronary Syndromes

Question: Is invasive therapy for acute coronary syndromes preferable to non-invasive? Are there any political or economic reasons for doctors to favor one type of treatment over the other?

Answer: It depends on the patient. For some, invasive is better, and for others, non-invasive is. Every patient is different, and there are risks and benefits associated with each approach. Physicians try to do what is best for the patient, but insurance companies may not pay for what is best medically. They opt for what is best for their bottom line.

Question: What is acute coronary syndrome/myocardial infarction? I was diagnosed with these after having several major tests...ct scans blood work,ultrasound,heart cath,I don't know everything I went through....any ways.. The cardiologist said I was very healthy and my heart and lungs looked great....and then he sent me home with papers on how to take care of myself with this acute coronary syndrome... I went in with rapid pulse and shortness of breath,and pain in my chest.

Answer: heart attack, in so many words. you had a heart attack.

Question: what is the difference between the pathophysiology of an Myocardial infarction and a acute coronary syndrome?

Answer: Acute coronary syndrome is an umbrella term for at least four subtypes of coronary presentations 1. Unstable angina 2. Non-ST elevation MI 3. ST elevation MI 4. Coronary spasm (organic or induced by cocaine, for instance) Given the broadness and even inclusion of MI within the term ACS then it is sort of futile to discuss pathophysiology. It is possible for an infarct to NOT have occurred and to still be classified as ACS (in the case of unstable angina). Further while ACS implies acute thrombus as the source of ischemia, it is not always necessary in the case of coronary spasm. I hope this clarifies. Good luck.

Question: What is Acute Coronary Syndrome?

Answer: I would accept what lovebug have stated, but there is another condition added to be predominant cause for ACS is Atherosclerotic plaque. ST elevation is in myocardial infarction, ST depression in myocardial ischemia Acute : Short period of time (few days) Coronary: Vessels of the Heart Syndrome: Multiple etiology associated with the condition

Question: what is acute coronary syndrome? my father died because of this deases. and i didnt understand about this. before he didnt have any chest pain. how it will possible to him to die because of it

Answer: An acute coronary syndrome (ACS) is a set of signs and symptoms, usually (but not always) a combination of chest pain and other features, interpreted as being the result of abruptly decreased blood flow to the heart (cardiac ischemia); the most common cause for this is the disruption of atherosclerotic plaque in an epicardial coronary artery. The subtypes of acute coronary syndrome include unstable angina (UA, not associated with heart muscle damage), and two forms of myocardial infarction (heart attack), in which heart muscle is damaged. Basically, the bloodflow to the heart was decreased, the heart tissue starved and died, and the heart stopped beating as a result. No heart beat leads to immediate death.

Question: What is the treatment of Heart Attack? Special treatments to open up your arteries Once your heart attack is diagnosed, your treatment begins immediately -- possibly right in the ambulance or emergency department. Medications>>>>>>>>>thrombolytic medications are used to break up clots blocking the artery The knowledge gained in the past years regarding acute coronary syndromes and what happens in the artery during a heart attack has helped guide medical treatment. The goals of medication therapy are to break up or prevent blood clots, prevent platelets from gathering and sticking to the plaque, stabilize the plaque, and prevent further ischemia, These medications must be given as soon as possible (within one to two hours from the start of your heart attack) to decrease the amount of damage. The longer the delay in starting these drugs, the more damage that occurs and the less benefit they can provide. Mediations for this purpose may include:>>>>>aspirin, heparin, thrombolytic therapy ("clot busters")

Answer: (m) Medications thrombolytic medications are used to break up clots blocking the artery The knowledge gained in the past years regarding acute coronary syndromes and what happens in the artery during a heart attack has helped guide medical treatment. The goals of medication therapy are to break up or prevent blood clots, prevent platelets from gathering and sticking to the plaque, stabilize the plaque, and prevent further ischemia, These medications must be given as soon as possible (within one to two hours from the start of your heart attack) to decrease the amount of damage. The longer the delay in starting these drugs, the more damage that occurs and the less benefit they can provide. Mediations for this purpose may include: aspirin heparin thrombolytic therapy ("clot busters") other antiplatelet drugs any combination of the above Other drugs, given during or after a heart attack lessen your heart's work, improve the functioning of the heart, widen or dilate your blood vessels, decrease your pain, and guard against any life-threatening heart rhythms. Your doctor will prescribe the appropriate medications for you. Interventional procedures During or shortly after a heart attack, you may go to the cardiac catheterization laboratory to directly evaluate the status of your heart, arteries and the amount of heart damage. In some cases, procedures (such as angioplasty or stents) are used to open up your narrowed or blocked arteries. These procedures may be combined with thrombolytic therapy to open up the narrowed arteries, as well as to break up any clots that are blocking them. Coronary artery bypass surgery If necessary, bypass surgery may be performed to restore the heart muscle's supply of blood.

Question: I am a laboratorian. I would like to know any of your experience with Ischemia Modified Albumin.? The Ischemia Modified Albumin is supposed to be used in patients with chest pain to rule out Acute Coronary Syndromes in low risk patients. Is anyone using this in their lab or practice?

Answer: Not yet. I work in a teaching hospital lab so I guess the new docs haven't had this lesson yet.

Question: Would it be ethically justified to have a trial of aspirin to patients, administered only during episodes of p A broad array of randomized trials have demonstrated the benefits of low doses of aspirin for both the primary and secondary prevention of CVD. Most trials demonstrate a 15% to 40% reduction in cardiovascular events with chronic aspirin use. Unfortunately many of our patients don't consume based on that information. A few who don't relish it much have been innovative to the point of swallowing aspirin only during brief episodes of chest pain maybe once or twice a week. That has had generalist physicians (who weakly boast of belonging to a problem solving specialty)thinking. Is the aspirin effect related to its preventing thrombus formation during acute plaque fissuring in acute coronary or cerebral syndromes or does it have any effect on the chronic stable plaque? If the effect is only on the fissured plaque, which is a one time event does it justify consuming it daily? Would it be ethically justified to have a trial of aspirin to patients, administered only during chest pain?

Answer: Are you saying to not have them take ASA any other time which would potentially prevent CVD by 14-40%? if that is the case, it will not be ethically justified at all. You can't take away the possible benefit just to have them enrolled in a trial! I would not want to be one of the subjects. Sorry.

Question: Does modern Feminism increase the risk of early atherosclerosis...? There is abundant literature that androgenetic alopecia in both men & ladies is, indeed, associated with greater insulin resistance and an increased risk of premature acute coronary syndromes: [Mansouri P, Mortazavi M, Eslami M, Mazinani M. Androgenetic alopecia and coronary artery disease in women. Dermatol Online J. 2005 Dec 1;11(3):2.] Is modern Feminism also correlated with such a significant increase in odds ratio and as such, shouldn't they be paying higher health insurance premiums for managment of ACS & all atherosclerotic complications compared to normal patients (particularly in a declining economy)?

Answer: Well Scientists in Sweden have found that gender equality is bad for the overall health of men and women http://www.ncbi.nlm.nih.gov/sites/entrez…

Question: What is abciximab? Monoclonal antibody with antithrombotic properties used to treat acute coronary syndrome and patients undergoing percutaneous coronary intervention procedures. What does this definition mean?

Answer: This is not a clost-buster drug, in that it does not prevent clots from forming. It is a monoclonal antibody of the 'fab' fragments of an immunoglobulin that targets a glycoprotein on the platelet receptor. Platelets are responsible for forming blood clots, they are a type of cell found in the blood stream. What this drug does is decrease platelet aggregation (it makes them less sticky). If the platelets don't stick together, then clots are less likely to form. It's used in angioplasty and stent patients to prevent clots from forming during the procedure. It has a shorter half-life (it sticks around in the body less) than some other drugs which do this, like heparin, warfarin and the like, which means the risks for complications due to prolonged bleeding are less compared to those other drugs. It can't dissolve clots once they form. You would need a kinease (a type of enzyme) for that.