What are acute coronary syndromes?
The term acute coronary syndrome has recently been adopted to include the three main clinical presentations of unstable coronary artery disease: – Acute ST-elevation MI (STEMI) – Non-ST-elevation MI (NSTEMI replaces the more traditional terms of non-Q-wave MI or sub-endocardial MI) – Unstable angina (Fox, 2000). The reason for this umbrella term is that it is now accepted that the three conditions share a very similar pathology. Unstable angina occupies the beginning of this spectrum, causing disability and a risk greater than stable angina but less than that of NSTEMI (Braunwald et al, 1994); although NSTEMI for many years was thought to have a similar prognosis to unstable angina some studies indicate that the prognosis for this group is similar to STEMI (Aguire et al, 1995; Zareba et al, 1994), which occupies the end of the spectrum. The terminology used to classify MI relates to the presence, or not, of ST-segment elevation on an electrocardiograph (ECG). The presence of such ECG c
