Management of Acute Coronary Syndrome

One of the most common complaints encountered in the emergency department is chest pain. In many evaluations, the leading diagnostic consideration is an acute coronary syndrome (ACS). ACS refers to a spectrum of coronary artery pathologies, including unstable angina, non-ST segment elevation myocardial infarction, and ST-segment elevation myocardial infarction. The distinction between subtypes of ACS guides acute diagnostic and management decisions. Failure to diagnose and manage ACS properly is a frequent cause of medico-legal litigation. In this article, we review the initial identification and critical management steps in patients presenting to the emergency department with ACS.