Acute coronary syndromes
Framing
- Acute coronary syndrome spans a spectrum from unstable angina/NSTEMI (partial coronary occlusion, no or partial-thickness infarction) to STEMI (complete occlusion, full-thickness infarction) - this distinction, made largely by ECG, determines the single most time-critical management decision: emergency reperfusion (primary PCI or thrombolysis) for STEMI versus risk-stratified, urgent (not emergency) invasive assessment for NSTEMI
- Both ends of the spectrum share the same underlying pathology (plaque rupture/erosion with superimposed thrombosis) and the same core secondary prevention pharmacotherapy once the acute event is managed
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