Critical decision making in the management of patients with acute myocardial infarction and other acute coronary syndromes

Optimal management of the patient with possible acute coronary syndrome cen ters on a series of key decisions. After the need for initial resuscitation is assessed and the patient is stabilized, other questions arise. Is there an acute cardiovascular condition requiring time-dependent treatment? If s o, how should disposition be determined with regard to admission decision, level of care, and testing to unmask underlying myocardium at risk? Finally , who should make these decisions? This discussion offers examples of exist ent institutional diagnosis and treatment pathways.