Complications
Acute coronary syndrome has been associated with an increased risk of VTE, particularly for pulmonary embolism.[142]
Congestive heart failure caused by decreased left ventricular (LV) function occurs frequently after acute coronary syndrome (ACS) because of myocardial damage, infarct progression, and LV remodelling after the acute episode. Heart failure post ACS may be more common in females than in males.[141]
Appropriate use of drugs, including beta-blockers, ACE inhibitors, angiotensin-II receptor antagonists, and diuretics, when appropriate, decreases the incidence and progression of congestive heart failure.
Biventricular pacing with or without an implantable cardioverter defibrillator should be considered if appropriate criteria are met.
Patients with acute coronary syndromes can have recurrent ischaemia or infarction caused by further plaque rupture and progression of atherosclerosis.
Recurrence should be treated in the same manner as the initial presentation.
Aggressive risk factor modification after the initial presentation decreases incidence of recurrences.
Depression is a risk factor for cardiovascular disease and for adverse outcomes after acute coronary syndrome (ACS).[57] ACS can also precipitate depression in people without prior psychiatric conditions.[57][138][139] Patients should routinely be screened for depression after a myocardial infarction.[139] Data suggest that a combined psychosocial approach to the treatment of depression improves outcomes in patients. Exercise combined with pharmacotherapy may be the most efficacious approach.[56] Pharmacotherapy may be associated with excess risk in patients with residual cardiac dysfunction; cognitive behavioural therapy or exercise therapy may be more appropriate in this patient group.[140]
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