Acute coronary syndrome (ACS) affects millions of patients annually and requires immediate diagnosis and therapy. Critically, given the aging global population, ACS is set to become an even greater medical problem, not only for the emergency room and cardiology physicians, but for all specialists treating the older population at risk of ACS. Advances in the treatment of ACS can justifiably be considered one of the great achievements of modern medicine. The evolution of treatment strategies represents a remarkable achievement, but there is an urgent need to educate those specialists treating the high-risk population. This practical algorithm-based handbook addresses the diagnosis and treatment of these patients and is designed for the medical personnel involved in the triage and management of ACS patients.

Acute Coronary Syndrome: Multidisciplinary and Pathway-Based Approach offers clinical assistance to all trainees and non-medical specialists and provides a framework for more experienced staff to manage ACS patients effectively. The authors have compiled a wealth of clinically useful tools and information drawn from their experience at St. Luke's-Roosevelt Hospital Center in New York, making this book a comprehensive evidence-based resource that allows readers to expand their knowledge and enables rapid diagnosis and treatment of patients with ACS.


Written for:
Emergency room staff (both physician and non-physician), internal medicine residents, cardiology fellows, internists, practicing cardiologists, all non-medical specialty trainees and attendings (e.g. surgical staff); ancillary personnel (e.g. nursing staff)
Contributors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xiii
1 Acute Coronary Syndrome: Where We Are, How We Got Here,
and Where We Are Going . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Jayanthi N. Koneru, Lance W. Weathers, and Michael Lesch
2 The PAIN Pathway for the Management of Acute
Coronary Syndrome . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Eyal Herzog, Emad Aziz, and Mun K. Hong
3 Translation of Critical Pathways for Acute Coronary Syndrome
into Admission Notes and Discharge Planning . . . . . . . . . . . . . . . . 20
Eyal Herzog, Emad Aziz, and Mun K. Hong
4 Epidemiology and Pathophysiology of Acute
Coronary Syndrome . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
Hossein Eftekhari, Inna Bukharovich, Emad Aziz,
and Mun K. Hong
5 Evaluation in the Emergency Department and
Cardiac Biomarkers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37
Gurusher Panjrath, Elaine B. Josephson, and Eyal Herzog
6 Diagnosis and Treatment of ST-Segment Elevation
Myocardial Infarction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48
Matthew Daka, Emad Aziz, Robert Leber, and Mun K. Hong
7 Diagnosis and Treatment of Non ST-Segment Elevation
Myocardial Infarction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60
Jacqueline E. Tamis-Holland, Sandeep Joshi, Angela Palazzo,
and Sripal Bangalore
8 Diagnosis and Treatment of Unstable Angina . . . . . . . . . . . . . . . . . 73
Aslam Khan, Robert Kornberg, and David L. Coven
9 Use of Stress Testing for the Risk Stratifi cation of Patients
at Low to Intermediate Event Risk According to the PAIN
Pathway Algorithm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 86
Seth Uretsky, Randy E. Cohen, and Alan Rozanski
10 The Role of Echocardiography in Acute Coronary Syndrome . . . . 96
Sandeep Joshi, Eyal Herzog, and Farooq A. Chaudhry
11 Mechanical Complications of Acute Myocardial Infarction . . . . . . 108
Gregory Janis, Atul Kukar, Eyal Herzog,
and Farooq A. Chaudhry
12 Diagnosis and Treatment of Congestive Heart Failure . . . . . . . . . . 119
David M. Wild, Emad Aziz, Eyal Herzog, and Marrick Kukin
13 Diagnosis and Treatment of Cardiogenic Shock . . . . . . . . . . . . . . . 132
Angela Palazzo, Sripal Bangalore, Jacqueline E. Tamis-Holland,
and Amy Chorzempa
14 Management of Pericardial Disease Complicating Acute
Coronary Syndrome . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 144
Seth Uretsky, Dan L. Musat, Mark V. Sherrid, and Eyal Herzog
15 Surgical Intervention in Acute Coronary Syndrome . . . . . . . . . . . . 154
Sandhya K. Balaram and Daniel G. Swistel
16 Arrhythmias Complicating Acute Myocardial
Infarction Bradyarrhythmias . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 163
Dan L. Musat, Delia Cotiga, Walter Pierce, and Aysha Arshad
17 Arrhythmias Complicating Acute Myocardial Infarction:
Atrial Tachyarrhythmias Including Atrial Fibrillation
and Atrial Flutter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 175
Dan L. Musat, Jonathan S. Steinberg, Delia Cotiga,
and Eyal Herzog
18 Ventricular Arrhythmias in Patients After
Myocardial Infarction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 190
Delia Cotiga, Tina Sichrovsky, Kataneh Maleki,
and Suneet Mittal
19 Management of Cocaine-Induced Chest Pain . . . . . . . . . . . . . . . . . . 204
Olivier Frankenberger, Tseday Sirak, Sripal Bangalore,
and Henry H. Greenberg
x Contents
20 Acute Coronary Syndrome in Women and the Elderly . . . . . . . . . . 212
Jacqueline E. Tamis-Holland, Catherine R. Weinberg,
Simbo Chiadika, and Bette Kim
21 Acute Coronary Syndrome in African Americans and
Hispanic Americans . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 229
Tseday Sirak, Simbo Chiadika, Matthew Daka,
and Claude Simon
22 Coronary Artery Spasm and Chest Pain with Normal
Coronary Arteries . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 246
Randy E. Cohen, Atul Kukar, Olivier Frankenberger,
and Henry H. Greenberg
23 Antihypertensive Therapy in the Acute Coronary
Syndrome Patient . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 264
Lauren Rosenberg, Gurusher Panjrath, Eyal Herzog,
and Franz Messerli
24 Hyperglycemia Complicating the Acute Coronary Syndrome:
Algorithm for Hyperglycemia Management During ACS . . . . . . . . 272
Emad Aziz, Eyal Herzog, and Nicholas H.E. Mezitis
25 Transition from Acute Phase to Chronic Phase: Secondary
Prevention for Patients with Cardiovascular Disease . . . . . . . . . . . 286
Merle Myerson
26 Smoking Cessation in the Cardiac Patient . . . . . . . . . . . . . . . . . . . . . 295
Mary O'Sullivan
27 Future Developments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 302
Khashayar Hematpour, Jamshad Wyne, and Mun K. Hong
Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .