ABSTRACT
In this review, recent key publications related to acute coronary syndrome (ACS) are summarized and placed into context of contemporary practice. Landmark trials examining vascular access in ST-elevation myocardial infarction, the management of multivessel disease, acute myocardial infarction and cardiac arrest are discussed. An update in pharmacology for ACS provides updates in major trials relating to P2Y12 inhibitor initiation, deescalation, and use in special populations. Additional updates in the use of lipid-lowering agents and adjunctive medications in ACS are reviewed. Finally, cardiac pathology related to coronavirus disease 2019 (COVID-19), as well as the impact of the COVID-19 global pandemic on the care of patients with ACS, is summarized.
Subject(s)
Acute Coronary Syndrome , COVID-19 , Myocardial Infarction , ST Elevation Myocardial Infarction , Acute Coronary Syndrome/diagnosis , Acute Coronary Syndrome/surgery , HumansSubject(s)
Attitude of Health Personnel , COVID-19 Nucleic Acid Testing , COVID-19/diagnosis , Cardiac Catheterization , Electrophysiologic Techniques, Cardiac , Health Knowledge, Attitudes, Practice , Mass Screening , Polymerase Chain Reaction , Female , Hospitals, University , Humans , Male , Middle Aged , Philadelphia , Predictive Value of Tests , Reproducibility of ResultsABSTRACT
A 57-year-old man acutely developed chest tightness and dyspnea. Given concern that his symptoms were consistent with COVID-19, the patient self-isolated. After 1 week of worsening symptoms, the patient presented with hypoxia and hypotension. He was found to have an occluded right coronary artery and ruptured posteromedial papillary muscle. (Level of Difficulty: Beginner.).