umbrella term used to cover any group of clinical symtpoms compatible with acute myocardial ischemia

chesp pain due to insufficient blood supply to the heart muscle that results from coronary artery disease (also called coronary heart disease)

Patients who have symptoms of acute myocardial ischemia and are given an electrocardiogram (ECG or EKG) may or may not have an ST elevation. What is so bad of a ST elevation?

Most patients who have ST-segment elevation will ultimately develop a Q-wave acute myocardial infarction (heart attack)!

either unstable angina or a non-ST segment elevation myocardial infarction that usually leads to a non-Q wave myocardial infarction

unstable angina to non-Q-wave myocardial infarction and Q-wave myocardial infarction

Age (men>45 y/o, women > 55 y/o or had early hysterectomy)

Family history of coronary event before age 55 y/o (men) or 65 y/o (women)

Smoking

Hypertension

Hyperlipidemia

Diabetes

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Severe pain radiating from sternum region of the chest to the left shoulder, arm, jaw, back or neck, diaphoresis, N/V, numbness/tingling sensation, shortness of breath

Precipitating factors include: exercise, cold weather, extreme emotions, sexual intercourse

Pain may be relieved by NTG (SL or spray) or rest

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UA: chest pain; cardiac enzymes are negative; no ECG changes (or transient)

NSTEMI: chest pain + positive cardiac enzymes

STEMI: chest pain + positive cardiact enzymes + ST segment changes on ECG (> 0.1 mV in 2 or more contiguous leads)