Myocardial Infarction and Acute Coronary Syndromes (ACS)


Acute Coronary Syndromes (ACS)

This is basically an umbrella term for:
  • STEMI – ST elevation MI
  • NSTEMI – non-ST elevation MI
  • Unstable angina
They are grouped together because – they all have a common mechanism –rupture or erosion of the fibrous cap of a coronary artery plaque.
Imagine it like a spectrum – with unstable angina at one end, and STEMI at the other – NSTEMI is in the middle.
For more information on the pathology, and a general overview of atherosclerotic disease, see the Atherosclerosis article



  • It is the most common cause of death in the UK
    • 50% of deaths occur within 2 hours of onset of symptoms
  • Incidence of 300 000 cases per year
  • More than 1.4m people in the UK suffer from angina – this also has incidence of approximately 2%
  • CAD accounts for about 3% of admission to UK hospitals each year



  • Age
  • Gender (male)
  • FH of IHD – only if symptoms present before the age of 55



  • Stress
  • Type ‘A’ personality
  • LVH – left ventricular hypertrophy
  • Cocaine use
  •  ↑ fibrinogen