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Acute Coronary Syndrome III: Diagnostic Studies

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Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...

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A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis

A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis

Published on: December 28, 2012

Diagnostic algorithms for non-ST-segment elevation myocardial infarction: open issues.

Aldo Clerico¹, Alberto Aimo¹, Martina Zaninotto²

¹Scuola Superiore Sant'Anna e Fondazione CNR - Regione Toscana G. Monasterio, Pisa, Italy.

Clinical Chemistry and Laboratory Medicine

|July 5, 2021

Summary

Serial measurement of cardiac troponin (cTn) aids myocardial infarction (MI) diagnosis. This review examines factors affecting high-sensitivity cTn (hs-cTn) changes and their impact on diagnosing non-ST-segment elevation MI (NSTEMI).

Keywords:

cardiac troponins cardiovascular risk guidelines high-sensitivity immunoassay quality specification reference population

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Ultrasonic Assessment of Myocardial Microstructure

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Published on: January 14, 2014

Area of Science:

Cardiology
Biochemistry

Background:

Serial measurement of cardiac troponin (cTn) is a cornerstone for diagnosing myocardial infarction (MI) since 2000.
High-sensitivity cardiac troponin (hs-cTn) assays have improved diagnostic capabilities.

Purpose of the Study:

To analyze factors influencing temporal changes in hs-cTn levels.
To evaluate the impact of these changes on the diagnosis of non-ST-segment elevation myocardial infarction (NSTEMI).
To identify discrepancies in recent international guidelines (2020-2021) for acute coronary syndromes (ACS).

Main Methods:

Review of international guidelines for ACS management.
Analysis of factors affecting hs-cTn kinetics.
Evaluation of diagnostic criteria for NSTEMI.

Main Results:

Significant discrepancies exist among recent guidelines regarding hs-cTn cut-off and absolute change values for NSTEMI rule-in.
Lack of consensus on sex-specific cut-off values for hs-cTn.
Insufficient evidence on the diagnostic accuracy and cost-effectiveness of proposed hs-cTn algorithms.

Conclusions:

Current guidelines show variability in hs-cTn interpretation for NSTEMI diagnosis.
Further research is needed to standardize hs-cTn use, particularly concerning sex-specific values and algorithmic approaches.
Harmonization of guidelines is crucial for consistent clinical practice in ACS management.