Acute coronary syndromes

Cardiac complaints are very common in office practice. Eliciting a history of chest pain, shortness of breath, or jaw/arm pain during a routine visit should prompt the physician to investigate these symptoms, and in some cases initiate appropriate management. The variety of therapeutic modalities available to physicians today, both invasive and non-invasive, should be well understood by all primary care physicians. In 1996, the National Center for Health Statistics reported over 1.4 million hospitalizations for unstable angina/non–ST-segment elevation myocardial infarction in the U.S.,1 while nearly 500,000 patients are hospitalized with ST-segment elevation myocardial infarction each year. Advancements in the acute coronary syndrome definitions and management change rapidly; this article will serve as a review and update for the Obstetrician-Gynecologist, who may be providing care for these women.