title: Acute Coronary Syndrome: Current Treatment.
abstract: Acute coronary syndrome continues to be a significant cause of morbidity and mortality in the United States. Family physicians need to identify and mitigate risk factors early, as well as recognize and respond to acute coronary syndrome events quickly in any clinical setting. Diagnosis can be made based on patient history, symptoms, electrocardiography findings, and cardiac biomarkers, which delineate between ST elevation myocardial infarction and non-ST elevation acute coronary syndrome. Rapid reperfusion with primary percutaneous coronary intervention is the goal with either clinical presentation. Coupled with appropriate medical management, percutaneous coronary intervention can improve short- and long-term outcomes following myocardial infarction. If percutaneous coronary intervention cannot be performed rapidly, patients with ST elevation myocardial infarction can be treated with fibrinolytic therapy. Fibrinolysis is not recommended in patients with non-ST elevation acute coronary syndrome; therefore, these patients should be treated with medical management if they are at low risk of coronary events or if percutaneous coronary intervention cannot be performed. Post-myocardial infarction care should be closely coordinated with the patient's cardiologist and based on a comprehensive secondary prevention strategy to prevent recurrence, morbidity, and mortality.
authors.affiliation: U.S. Army Medical Department Center and School, Fort Sam Houston, TX, USA.
authors.forename: Timothy L
authors.initials: TL
authors.lastname: Switaj
authors.affiliation: Martin Army Community Hospital Family Medicine Residency Program, Fort Benning, GA, USA.
authors.forename: Scott R
authors.initials: SR
authors.lastname: Christensen
authors.affiliation: Guthrie Ambulatory Health Care Clinic, Fort Drum, NY, USA.
authors.forename: Dean M
authors.initials: DM
authors.lastname: Brewer
mesh_terms: D054058:Acute Coronary Syndrome / Q000175:diagnosis* / Q000188:drug therapy*; D004502:Education, Medical, Continuing; D004562:Electrocardiography; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D017410:Practice Guidelines as Topic; D011320:Primary Health Care / Q000592:standards*; D012307:Risk Factors; D015912:Thrombolytic Therapy; D016896:Treatment Outcome; D014481:United States
chemical_list: D005343:Fibrinolytic Agents