The Journal of the American Osteopathic Association
-
J Am Osteopath Assoc · Nov 2000
ReviewThrombolytic, antithrombin, and antiplatelet treatment of acute coronary syndromes.
Acute coronary syndromes are a major public health problem and the leading cause of death in the western world. Acute coronary syndromes consist of unstable angina pectoris, non-ST-segment-elevation myocardial infarction, and ST-segment-elevation myocardial infarction. These diseases represent a continuum of increasing severity and are pathophysiologically linked to intracoronary thrombus formation that is nonocclusive, transiently occlusive, or completely occlusive, respectively. ⋯ Newer intravenous antiplatelet agents reduce 30-day mortality and myocardial infarction in unstable angina and non-ST-segment-elevation myocardial infarction. Adenosine diphosphate antagonist antiplatelet agents have an ill-defined role in the treatment of acute coronary syndromes. Fibrinolytic therapy has been shown to reduce mortality in ST-segment-elevation myocardial infarction but may pose a hazard in other acute coronary syndromes.
-
More than 5 million Americans visit hospital emergency departments each year with the complaint of chest pain. Two million patients are admitted to hospitals because of chest pain, but the diagnosis of coronary heart disease is confirmed in only one fourth of them. ⋯ The goal of management of patients with acute coronary syndrome is to rapidly recognize and manage their cardiac ischemic event, define the risk of myocardial ischemia and recurrent cardiac events, and minimize unnecessary risk to the patient. These decisions can all be made by the use of standard clinical descriptors that include chest pain, the electrocardiogram, and biochemical markers of myocardial injury during and after an acute ischemic episode.
-
J Am Osteopath Assoc · Nov 2000
Biography Historical Article Classical ArticleEducational fundamentals in osteopathy. 1946.