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1、EmergencyofCardiovascularSystemDepartmentofEmergency,XuanwuHospitalofCapitalMedicalUniversityAcutecoronarysyndromeArrhythmiaAcuteheartfailureHypertensiveemergencyPart1AcutecoronarysyndromeAgroupofclinicalsyndromecausedbyacutemyocardialischemia.Coronaryatherosclerosisisthepathologicalbasisofthi
2、skindofdisease.Itoccursbecauseofacutemyocardialhypoxia,andtheimbalanceofmyocardialoxygensupplyanddemand.MostofthediseasedeterioratefromchronicstableanginaConceptIntroductionACSisadynamicevolutionaryprocess.Itcanbedividedintounstableangina,nonST-segmentelevationmyocardialinfarctionandSTsegmente
3、levationmyocardialinfarctionaccordingtotheseverityofacutemyocardialhypoxia,thedurationandtheimbalanceofoxygensupplyTheresultofongoingischemiaismyocardialinfarctionregardlessofanykindsofmyocardialischemia.ThepathogenesisofACSisadynamicprocess.Sowewillbeabletosavepartoftheischemicmyocardium,redu
4、cedinfarctsize,orevenavoidtheoccurrenceofmyocardialinfarctionifearlyidentificationandrapideffectivetreatmentsarecarriedout.Type1:IncludingunstableanginaandnonSTsegmentelevationmyocardialinfarction.TheLumenofbloodvesselinNon-STsegmentelevationmyocardialinfarctionisincompleteocclusionbecauseofth
5、eplateletthrombus,knownasawhitethrombus.Type2:theSTsegmentelevationmyocardialinfarction.Thethrombusisfibrin-based,alsoknownasredthrombus,totalocclusionofthelumen.ClinicalClassificationACSdependsontwokindsoffactors:One:theformationofcoronaryatheroscleroticplaques.Second:includingplaquerupture,p
6、lateletactivation,leadingtothrombosis,resultinginlumenobstruction.Generally,atheroscleroticplaquescancausevascularstenosis,butnotcompletelyblocked,andifthereisthrombosis,itiseasytoblockthevessellumen.MechanismInaddition,duetotheimpairedendothelial,prostacyclinandrelaxingfactor(EDRF)releaseredu
7、ced,andangiotensinⅡ(AngⅡ)generationincreased,whichleadtovasoconstriction,plateletaggregationandacceleratethrombosis.DiagnosisanddifferentialdiagnosisAccordingtohistoryandclinicalmanifestations,ECGchangesandcardiacmarkerssuchastroponinT(
