[Conservative management in patients with acute coronary syndrome]

Plaque rupture has been thought to cause acute coronary syndrome. To manage the patients with unstable angina, it is necessary to understand the patients' pathophysiology. Based on the classification of unstable angina, initial medical treatment including aspirin and oral isosorbide dinitrate should be started immediately after admission. Ca antagonist and beta-blocking agent should be added according to the symptoms. If ischemic symptoms continue after administration of those oral medical treatments, intravenous nitroglycerin and heparin should be started. K channel opener (nicorandil) may be effective to stabilize the symptom. However, high-risk patients should immediately receive coronary angiography to decide further medical or interventional therapy.