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The year in cardiology 2018: acute coronary syndromes


Widimsky, Petr; Crea, Filippo; Binder, Ronald K; Lüscher, Thomas F (2019). The year in cardiology 2018: acute coronary syndromes. European Heart Journal, 40(3):271-282.

Abstract

The management of acute coronary syndromes (ACS) is a true success story. Indeed, in 1955 when the then President of the United States Dwight D. Eisenhower had an infarction, the President’s personal physician, Dr Howard Snyder, interpreted his symptoms as a gastrointestinal illness.1 It took 10 h to transfer him to a local hospital where an electrocardiograph had to be brought in from another hospital—a situation that today would be malpractice.2 The electrocardiogram (ECG) showed an anterolateral acute myocardial infarction (AMI) with ST-segment elevation myocardial infarction or a STEMI as we would call it today based on the recent definition of myocardial infarction (MI).3 Based on the Fourth Universal Definition of Myocardial Infarction Eisenhower experienced a clear cut Type 1 infarction (Table 1). Today, we distinguish not only five types of infarction, but also myocardial injury, defined by an elevated cardiac troponin (cTn) value, which is also associated with an adverse prognosis. To differentiate myocardial injury from MI, criteria in addition to abnormal biomarkers are required such as ECG changes and evidence of ischaemia.

Abstract

The management of acute coronary syndromes (ACS) is a true success story. Indeed, in 1955 when the then President of the United States Dwight D. Eisenhower had an infarction, the President’s personal physician, Dr Howard Snyder, interpreted his symptoms as a gastrointestinal illness.1 It took 10 h to transfer him to a local hospital where an electrocardiograph had to be brought in from another hospital—a situation that today would be malpractice.2 The electrocardiogram (ECG) showed an anterolateral acute myocardial infarction (AMI) with ST-segment elevation myocardial infarction or a STEMI as we would call it today based on the recent definition of myocardial infarction (MI).3 Based on the Fourth Universal Definition of Myocardial Infarction Eisenhower experienced a clear cut Type 1 infarction (Table 1). Today, we distinguish not only five types of infarction, but also myocardial injury, defined by an elevated cardiac troponin (cTn) value, which is also associated with an adverse prognosis. To differentiate myocardial injury from MI, criteria in addition to abnormal biomarkers are required such as ECG changes and evidence of ischaemia.

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Additional indexing

Item Type:Journal Article, refereed, further contribution
Communities & Collections:04 Faculty of Medicine > Center for Molecular Cardiology
Dewey Decimal Classification:610 Medicine & health
Scopus Subject Areas:Health Sciences > Cardiology and Cardiovascular Medicine
Language:English
Date:14 January 2019
Deposited On:21 Jan 2020 12:58
Last Modified:29 Jul 2020 12:54
Publisher:Oxford University Press
ISSN:0195-668X
OA Status:Green
Free access at:Publisher DOI. An embargo period may apply.
Publisher DOI:https://doi.org/10.1093/eurheartj/ehy904
PubMed ID:30601993

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