Non St Elevation Acute Coronary Syndrome: Contemporary Management Strategies

The term, acute coronary syndrome (ACS), describes a spectrum of clinical conditions ranging from ST-segment elevation myocardial infarction (STEMI) to non–ST-segment elevation MI (N–STEMI) and unstable angina (UA) (Fig. 119.1) (1). These manifestations of acute myocardial ischemia may revert to the presymptomatic state or evolve into a non-Q wave (also termed nontransmural) MI or to Q wave (or transmural) MI (Fig. 119.1). The boundaries between UA, N-STEMI, and STEMI are not always well defined. Indeed, the three entities should be considered as different and dynamic clinical manifestations of a continuous pathogenetic spectrum; N-STE-ACS are represented by UA and N-STEMI.