Among patients with ACS, women present more often with unstable angina, representing 30% to 45% of patients with this condition, compared with 25% to 30% of patients with NSTEMI and only 20% of patients with STEMI.[7] In comparison to the latter, patients with UA/NSTEMI are older and have higher rates of prior MI, stable angina, diabetes, previous coronary revascularization, and extracardiac vascular disease than do patients with STEMI.[7] Indeed, approximately 80% of patients with UA/NSTEMI have a history of coronary artery disease (CAD) before the acute event.[8]
Clinical ExaminationThe physical examination may be unremarkable or may support the diagnosis of cardiac ischemia. Signs suggesting that ischemia involves a large fraction of the left ventricle include diaphoresis, pale cool skin, sinus tachycardia, a third or fourth heart sound, and basilar rales on lung examination. In some patients, ischemia of a large area of myocardium reduces left ventricular dysfunction …
