Cardiology Teaching Package
A Beginners Guide to Normal Heart Function, Sinus Rhythm & Common Cardiac Arrhythmias
Acute Coronary Syndrome
Introduction and history
Acute Coronary Syndrome (ACS) is a relatively new term in cardiology, having been formally introduced in 2001 following biochemical breakthrough in infarct detection. So, with new blood tests it is possible to identify much smaller areas of heart tissue death. Up until 1996, the basis for diagnosis of acute myocardial infarction (AMI) originated from the World Health Organisation (WHO) 1981.
The criteria included:
- A clinical account of chest pain
- ECG changes (see examples further on)
- Serial changes in cardiac enzymes (detectors of myocardial damage)
In 1996, the American Heart Association (AHA) Scientific statement proposed the use of Creatinine Kinase MB (CKMB) as the preferred marker for diagnosis of AMI. This was a step forward at the time because, although creatinine kinase (CK) is not specific to the heart, previously used markers were less dependable.
However, during the late 1980's and throughout the 1990's, major research undertakings had been carried out into the use of another biochemical marker called Troponin.
