12/31/2022 0 Comments Class iii angina![]() ![]() Until recently, distinguishing among these three acute entities has been a central diagnostic goal because of the apparent therapeutic implications based on clinical trials. With UA, no myocardial necrosis occurs the distinction between QMI and NQMI resides in the development of electrocardiographic Q waves (3,4), although there are short and long term clinical implications as well. All are related pathogenetically, as each represents different stages of plaque rupture and thrombosis. Unstable angina (UA), non-Q wave myocardial infarction (NQMI), and Q wave myocardial infarction (QMI) constitute the diagnoses collectively termed “the acute coronary syndromes” (1,2). ![]() Based on these results, it is likely that newer therapies such as glycoprotein IIb/IIIa receptor antagonists, low molecular weight heparins, and coronary stents will be directed toward these high risk patients. In the late 1990’s, although UA and NQMI remain parts of a spectrum, it is apparent that the distinction between these two entities is no longer sufficient to identify high risk patients rather, specific electrocardiographic changes, aspects of the clinical history, newer biochemical markers, and angiographic findings help to better distinguish higher risk individuals from a large patient population with unstable coronary syndromes and these factors usually determine therapy.Ĭonclusions. Recent abstracts were also considered and cited where appropriate. Manuscripts published in peer-reviewed journals over the past three decades were reviewed and selected for this review. In the past, enzyme differentiation of NQMI from UA was considered important to assess prognosis and direct therapy. Patients with unstable angina (UA) and non-Q wave myocardial infarction (NQMI) may sustain a small amount of myocardial loss but have significant amounts of viable, yet ischemic, myocardium, placing them at high risk for future cardiac events. ![]() Patients with acute coronary syndromes comprise a large subset of many cardiology practices. The goal of this review is to reevaluate the unstable coronary syndromes in the setting of new therapies and biochemical markers.īackground. ![]()
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