Acute Coronary Syndromes

 

Description:

 

Acute Coronary Syndrome (ACS) is a growing global menace with patients increasing in developing countries where tobacco and food play a major role. Its treatment guidelines and research results have proliferated in academia, but practical applications lag behind that research. This book addresses this void. Guidelines for treatment of ACS present in-depth reading for practicing cardiologists, thus preventing clinical application. The book aims to appraise readers of real-world situations and suggestions to help them acquire up-to-date knowledge on ACS and its effective diagnosis, prognosis and management. Key Features Covers recent advances in ACS management and pharmacotherapy Discusses the guidelines for treatment of ACS for the professional cardiologist to apply to clinical practice Explores the topics with the help of case scenarios Follows a concise, yet comprehensive approach Features a chapter on 'When to Transfer,' which discusses how to spot unstable patients or those heading towards shock

 

Table of Contents:

 

 

1. Epidemiology of acute coronary syndromes in India

India: Coronary capital of the world

Acute coronary syndromes in india

Geographic epidemiology

Clinical and pharmacoepidemiology

Genetic epidemiology

Conclusion

References

2. Pathophysiology of acute coronary syndrome

Introduction

Atherogenesis

Mechanisms of Thrombosis

Symptomology in Relation to Coronary Thrombi

Plaque Disruption: The Healing Process

In Vivo Culprit Lesion Assessment in ACS by Optical Coherence Tomography

Myocardial Infarction with Non-Obstructive Coronary Arteries

Conclusion

References

3. Current outcomes and outcome measures in acute coronary syndrome

Introduction

ST-Elevation Myocardial Infarction (STEMI)

Non-ST-Elevation Myocardial Infarction

Incidence and Outcomes in Contemporary Care

Risk Assessment in NSTEMI

Basic Management

Anti-Platelet Therapy

Anti-Coagulation

Invasive versus Conservative Management

Timing of Invasive Management

Culprit Vessel versus Multi-vessel PCI

PCI versus Coronary Artery Bypass Grafting

References

4. Clinical syndromes in acute coronary syndrome: Angina and its equivalents

Introduction

Pathophysiology

Chest Discomfort/Pain

Anginal Pain Equivalents

Atypical Presentations

Conclusion

References

5. ECG spectrum in acute coronary syndrome

ECG Spectrum in Acute Coronary Syndromes

ECG Diagnosis of Myocardial Infarction with Bundle Branch Blocks

Lead aVR in Acute Coronary Syndromes

Abnormal Q waves

Potential Confounders in ECG Changes in ACS

Anterior Wall ST-Elevation MI Equivalents

Myocardial Ischaemia and Repolarisation Changes

References

6. Arrhythmias in acute coronary syndrome

Introduction

Ventricular tachyarrhythmias

Supraventricular arrhythmias

Conclusion

References

7. Intravascular imaging in acute coronary syndrome

Introduction

Intravascular imaging modalities

Intravascular imaging: tissue characterisation

Intravascular imaging in ACS

Intravascular imaging-guided intervention to prevent no-reflow

Imaging-guided stent implantation

Conclusion

References

8. Cardiac biomarkers in acute coronary syndrome

Introduction

Traditional cardiac biomarkers

Conclusion

References

9. Risk stratification in acute coronary syndromes

Introduction

Determination of risk factors and pre-test assessment

ECG aspect

Stress test

Interventional aspect

Observational studies and using additional predictors

References

10. Initial therapy and when to transfer at non-pci centres

Doctor’s clinic or PHC

A secondary care centre or a community health centre (CHC) with AN ECG facility

A district hospital/secondary care centre where thrombolysis is possible

Conclusion

References

11. Anti-platelet therapy in acute coronary syndrome: What is current and new?

Currently approved oral anti-platelet agents in ACS

Intravenous anti-platelet agents in ACS

References

12. Current status of fibrinolytic therapy

Introduction

Indications of fibrinolytic therapy

Pre-hospital fibrinolysis

Late therapy

Choice of fibrinolytic agent

Intracoronary fibrinolysis

Adjunctive use of anti-platelets

Adjunctive use of antithrombotics

Hazards of fibrinolytic therapy

Contraindications of fibrinolysis

Transfer of patients after fibrinolysis

Choice of reperfusion therapy

References

13. Anti-coagulation in acute coronary syndrome

Introduction

Pathophysiology of ACS and role of anti-coagulation

Anti-coagulants used in ACS

Anti-coagulation in STEMI

Anti-coagulation in NSTEMI

Newer anti-coagulants in ACS

Guidelines

Future vision

Conclusion

References

14. Contentious issues in primary angioplasty: Deferred stenting, manual thrombectomy, culprit versus complete revascularisation, microvasculature in ACS

Manual thrombectomy

Deferred stenting

Culprit-only revascularisationversus complete revascularisation

Revascularisation in patients with cardiogenic shock

References

15. PCI post-thrombolysis: When and for whom?

Approach to the patient

References

16. PCI in unstable angina and NSTEMI

Introduction

Epidemiology and natural history

Pathophysiology

Diagnosis

Differential diagnosis

Risk assessment

Management

Conclusion

References

17. Bleeding in acute coronary syndrome

Introduction

Incidence and site of bleeding in ACS

Bleeding definitions

Risk factors for bleeding in ACS

Effect of drugs on bleeding in ACS

Adverse outcomes with bleeding in ACS

Management of bleeding in ACS

Prevention of bleeding in ACS

Conclusion

References

18. Statins in acute coronary syndrome

Introduction

Acute coronary syndrome

Statins and their actions

Guidelines

Conclusion

References

19. Intravenous anti-platelet therapy—GP IIb/IIIa blockers and cangrelor: What has changed recently?

Introduction

Timing and method of administration

Recent guidelines

Conclusion

References

20. CABG in acute coronary syndrome

CABG in non-st-elevation MI ACS

CABG in st-elevation MI

Timing of surgery

Anti-platelet/fibrinolytic therapy

Pre-operative management

Technical considerations

Outcomes of CABG in ACS

CABG versus PCI in ACS

Cardiogenic shock: recommendations

OPCAB in ACS

Mechanical circulatory support in ACS

Post-operative pharmacotherapy

Future

Conclusion

References

21. Acute coronary syndrome with haemodynamic instability

Introduction

Causes of haemodynamic instability in ACS

Pathophysiology

Clinical features

Investigations and diagnosis

Differential diagnosis

Management

conclusion

References

22. Acute coronary syndrome in special populations: Women, the elderly, chronic kidney disease and the young

Introduction

ACS in women

ACS in the elderly

ACS in CKD patients

Contrast-induced nephropathy (IN)

ACS in the young

Conclusion

References

23. Short-term rehabilitation after an acute coronary event

Benefits of cardiac rehabilitation after ACS

Components of cardiac rehabilitation after ACS

Conclusion

References

24. Acute coronary syndrome: Case-based scenarios

Introduction

Case scenario 1

Case scenario 2

Case scenario 3

Conclusion

References

25. Quality improvement programme for acute coronary syndrome care in India

Introduction

Brief history of cardiovascular health care quality improvement

Fundamental concepts related to quality, safety and quality improvement

Cardiovascular health care quality improvement programmes in ACS in India

Challenges, opportunities and future directions

Conclusion

Acknowledgement

References

26. Primary angioplasty: Basic principles

Introduction

Various treatment strategies for acute STEMI

Limitations of fibrinolysis

Primary PCI: Goals, time logistics, why and in which situations?

Basic terminologies related to primary PCI timing

Procedural aspects of interventions during PPCI

Prevention of distal embolisation in PPCI

Role of covered stents and distal embolisation devices in PPCI

Role of glycoprotein IIb/IIIa inhibitors (GPIs) in PPCI

Intracoronary pharmacotherapy in PPCI

Intracoronary fibrinolytics

Technical issues in primary PCI

Stenting in primary PCI

Selection of stent type in PPCI

Role of intra-Aortic balloon pump (IABP) in PPCI

Role of intracoronary imaging in PPCI

Primary PCI in special situations

PPCI in cardiogenic shock

Conclusion

References

27. Management of acute coronary syndromes in acute phase in India: Relevance of Western guidelines

Introduction

Clinical spectrum

Diagnosis and initial assessment

Risk stratification

Management strategies for NSTE-ACS

Guideline-mandated management strategies

Invasive coronary angiography and revascularisation

Revascularisation strategies

Relevance of the guidelines for clinical practice in india

Conclusion

References

Index

 

An aparitie	16 July 2020
Autor	K Sarat Chandra , AJ Swamy
Dimensiuni	20.96 x 1.27 x 27.31 cm
Editura	CRC Press
Format	Paperback
ISBN	9780367112226
Limba	Engleza
Nr pag	224