急性冠狀動脈症候群

急性冠狀動脈綜合徵
急性冠狀動脈綜合徵
	冠狀動脈阻塞示意圖
類型	冠狀動脈疾病、coronary syndrome[*]
分類和外部資源
醫學專科	心臟病學
ICD-10	I24.9
MedlinePlus	[1]
eMedicine	emerg/31
MeSH	D054058
	[編輯此條目的維基數據]

急性冠狀動脈綜合徵（acute coronary syndrome，ACS）又稱急性冠脈綜合徵^[1]^[2]，是一組由急性心肌缺血引起的臨床綜合徵，包括不穩定型心絞痛、急性心肌梗死、心源性猝死。

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ACS成因是冠狀動脈內粥樣斑塊破裂、表面破損或出現裂紋，繼而出血和血栓形成，引起冠狀動脈不完全或完全梗阻，以致心肌供血嚴重不足的臨床綜合徵。其臨床表現為不穩定型心絞痛、急性心肌梗死或心源性猝死。最常見的症狀是胸部有擠壓般的疼痛，常放射至左臂或下頜角點（gonion），並伴有噁心和出汗。

ACS分型在中國的占比為：急性心肌梗死約占65％（ST段抬高型心肌梗死^[3]（ST elevation myocardial infarction, STEMI）約50％，非ST段抬高型心肌梗死^[4]（non ST elevation myocardial infarction, NSTEMI）約15％-20%）以及不穩定型心絞痛（unstable angina）約占25%-35％^[5]^[6]。

相對於急性冠脈綜合徵的，稱為慢性冠脈綜合徵，兩者皆屬於冠狀動脈疾病^[7]^[8]^[9]。

參考

[1]
弗倫.急性冠脈綜合徵心電圖[M].北京大學醫學出版社,2007.
[2]
楊新春.急性冠脈綜合徵基礎與臨床[M].人民軍醫出版社,2003.
[3]
中國醫師協會急診醫師分會, 國家衛健委能力建設與繼續教育中心急診學專家委員會, 中國醫療保健國際交流促進會急診急救分會. 急性冠脈綜合徵急診快速診治指南(2019) [J] . 中華急診醫學雜誌, 2019, 28(4) : 421-428. DOI: 10.3760/cma.j.issn.1671-0282.2019.04.003.
[4]
李毅,韓雅玲. 2023 ESC急性冠脈綜合徵管理指南解讀[J]. 中華心血管病雜誌,2023,51(12)：1263-1267. DOI:10.3760/cma.j.cn112148-20230920-00175
[5]
Han XN, Qiao SB, Ge JB, Han YL, Chen JY, Yuan ZY, Yu B, Jiang J, Huo Y. Long-term follow-up of antithrombotic management patterns in patients with acute coronary syndrome in China. J Geriatr Cardiol. 2020 May;17(5):246-255. doi: 10.11909/j.issn.1671-5411.2020.05.008. PMID 32547607; PMCID: PMC7276310.
[6]
Si-Yi Li, Ming-Gang Zhou, Tao Ye, Lian-Chao Cheng, Feng Zhu, Cai-Yan Cui, Yu-Mei Zhang, Lin Cai. Frequency of ST-segment elevation myocardial infarction, non-ST-segment myocardial infarction, and unstable angina: results from a Southwest Chinese Registry. Rev. Cardiovasc. Med. 2021, 22(1), 239–245. https://doi.org/10.31083/j.rcm.2021.01.103
[7]
2023 AHA/ACC/ACCP/ASPC/NLA/PCNA Guideline for the Management of Patients With Chronic Coronary Disease: A Report of the American Heart Association/American College of Cardiology Joint Committee on Clinical Practice Guidelines
[8]
Juhani Knuuti, William Wijns, Antti Saraste et al. , ESC Scientific Document Group , 2019 ESC Guidelines for the diagnosis and management of chronic coronary syndromes: The Task Force for the diagnosis and management of chronic coronary syndromes of the European Society of Cardiology (ESC), European Heart Journal, Volume 41, Issue 3, 14 January 2020, Pages 407–477, https://doi.org/10.1093/eurheartj/ehz425
[9]
Ueng KC, Chiang CE, Chao TH, et al. 2023 Guidelines of the Taiwan Society of Cardiology on the Diagnosis and Management of Chronic Coronary Syndrome [published correction appears in Acta Cardiol Sin. 2023 Nov;39(6):946]. Acta Cardiol Sin. 2023;39(1):4-96. doi:10.6515/ACS.202301_39(1).20221103A

外部連結

[1] [1]
弗倫.急性冠脈綜合徵心電圖[M].北京大學醫學出版社,2007.

[2] [2]
楊新春.急性冠脈綜合徵基礎與臨床[M].人民軍醫出版社,2003.

[3] [3]
中國醫師協會急診醫師分會, 國家衛健委能力建設與繼續教育中心急診學專家委員會, 中國醫療保健國際交流促進會急診急救分會. 急性冠脈綜合徵急診快速診治指南(2019) [J] . 中華急診醫學雜誌, 2019, 28(4) : 421-428. DOI: 10.3760/cma.j.issn.1671-0282.2019.04.003.

[4] [4]
李毅,韓雅玲. 2023 ESC急性冠脈綜合徵管理指南解讀[J]. 中華心血管病雜誌,2023,51(12)：1263-1267. DOI:10.3760/cma.j.cn112148-20230920-00175

[5] [5]
Han XN, Qiao SB, Ge JB, Han YL, Chen JY, Yuan ZY, Yu B, Jiang J, Huo Y. Long-term follow-up of antithrombotic management patterns in patients with acute coronary syndrome in China. J Geriatr Cardiol. 2020 May;17(5):246-255. doi: 10.11909/j.issn.1671-5411.2020.05.008. PMID 32547607; PMCID: PMC7276310.

[6] [6]
Si-Yi Li, Ming-Gang Zhou, Tao Ye, Lian-Chao Cheng, Feng Zhu, Cai-Yan Cui, Yu-Mei Zhang, Lin Cai. Frequency of ST-segment elevation myocardial infarction, non-ST-segment myocardial infarction, and unstable angina: results from a Southwest Chinese Registry. Rev. Cardiovasc. Med. 2021, 22(1), 239–245. https://doi.org/10.31083/j.rcm.2021.01.103

[7] [7]
2023 AHA/ACC/ACCP/ASPC/NLA/PCNA Guideline for the Management of Patients With Chronic Coronary Disease: A Report of the American Heart Association/American College of Cardiology Joint Committee on Clinical Practice Guidelines

[8] [8]
Juhani Knuuti, William Wijns, Antti Saraste et al. , ESC Scientific Document Group , 2019 ESC Guidelines for the diagnosis and management of chronic coronary syndromes: The Task Force for the diagnosis and management of chronic coronary syndromes of the European Society of Cardiology (ESC), European Heart Journal, Volume 41, Issue 3, 14 January 2020, Pages 407–477, https://doi.org/10.1093/eurheartj/ehz425

[9] [9]
Ueng KC, Chiang CE, Chao TH, et al. 2023 Guidelines of the Taiwan Society of Cardiology on the Diagnosis and Management of Chronic Coronary Syndrome [published correction appears in Acta Cardiol Sin. 2023 Nov;39(6):946]. Acta Cardiol Sin. 2023;39(1):4-96. doi:10.6515/ACS.202301_39(1).20221103A

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