Acute coronary syndrome is associated with all EXCEPT
High-Yield Explanation
(B) Stable angina # Unstable Angina & Non-ST-elevation Myocardial Infarction:> Patients with ischemic heart disease fall into two large groups: patients with stable angina secondary to chronic coronary artery disease and patients with acute coronary syndromes (ACS).> Latter group, in turn, is composed of patients with acute myocardial infarction (Ml) with ST-segment elevation on their presenting electrocardiogram (STEMI) and those with unstable angina (UA) and non-ST-segment elevation Ml (UA/NSTEMI).> Every year in the United States, ~1.4 million patients are admitted to hospitals with UA/NSTEMI as compared with 400,000 patients with acute STEMI.> The diagnosis of UA is based largely on the clinical presentation.> Stable angina pectoris is characterized by chest or arm discomfort that is rarely described as pain, but that is reproducibly associated with physical exertion or stress and is relieved within 5 to 10 min by rest and/or sublingual nitroglycerin.> UA is defined as angina pectoris or equivalent ischemic discomfort with at least one of three features:(1) it occurs at rest (or with minimal exertion) usually lasting >10 min,(2) it is severe and of new onset (i.e., within the prior 4 to 6 weeks), and/or(3) it occurs with a crescendo pattern (i.e., distinctly more severe, prolonged, or frequent than previously).> The diagnosis of NSTEMI is established if a patient with the clinical features of UA develops evidence of myocardial necrosis, as reflected in elevated cardiac biomarkers.