Initial Appraisal of Acute Coronary Syndromes
Acute coronary syndrome remains a daunting health care problem in the United States. One third of emergency department patients with chest pain will eventually have a diagnosis of acute coronary syndrome. During the past decade, there have been many advances in the treatment of acute coronary syndrome as well as a widespread movement in emergency medicine to streamline the process of its treatment. Goals of emergency department care include rapid identification of patients with acute myocardial infarction, exclusion of causes of nonischemic chest pain, stratification of patients with acute coronary ischemia into low-risk and high-risk groups, and initiation of pharmacologic treatments. These goals will be discussed in this review, with particular emphasis on pharmacologic treatments.