Acute coronary syndrome

Last revised by Henry Knipe on 11 Apr 2019

Acute coronary syndrome (ACS) is a group of cardiac diagnoses along a spectrum of severity due to the interruption of coronary blood flow to the myocardium, which in decreasing severity are:

  • ST elevation myocardial infarction (STEMI)
  • non-ST elevation myocardial infarction (NSTEMI)
  • unstable angina

Stable angina is not considered an ACS.

Of all patients who present to emergency departments with symptoms of ACS, only 20-25% will have ACS confirmed as their discharge diagnosis 1,2

The most common cause by far is atherosclerotic plaque rupture in coronary artery disease. Other less common causes include:

Unusual variants:

Several other pathological entities may mimic an acute coronary syndrome in both electrocardiographic appearance and clinical presentation;

Other serious causes of acute chest pain which may mimic the presentation of ACS include;

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