Acute coronary syndrome

Abstract

Cardiovascular disorders remain a leading cause of morbidity and mortality worldwide, encompassing a wide range of clinical entities such as acute coronary syndrome (ACS), hypertension, metabolic syndrome, rhythm disturbances, and circulatory insufficiency. This comprehensive review explores the pathophysiological mechanisms, diagnostic strategies, and evidence-based management approaches for these conditions in a clinically relevant and human-centered manner.

In acute coronary syndrome, the interplay between atherosclerotic plaque rupture, thrombus formation, and myocardial ischemia defines its pathophysiology. Early diagnosis through ECG and cardiac biomarkers, followed by timely reperfusion and dual antiplatelet therapy, remains the cornerstone of care. Arterial hypertension, driven by neurohormonal and vascular dysregulation, demands accurate diagnosis, lifestyle modification, and pharmacological therapy individualized to patient risk profiles.

The metabolic syndrome, characterized by central obesity, insulin resistance, dyslipidemia, and hypertension, represents a major link between metabolic dysfunction and cardiovascular disease. Addressing it through weight reduction, diet optimization, and insulin-sensitizing agents such as metformin or GLP-1 receptor agonists can significantly improve outcomes.

Cardiac rhythm disorders, including atrial fibrillation and ventricular arrhythmias, result from electrical disturbances within the myocardium. Management combines rate or rhythm control strategies with anticoagulation and device-based interventions where indicated. Circulatory insufficiency, manifested as heart failure or cardiogenic shock, reflects advanced cardiac dysfunction requiring multifaceted management—from diuretics and inotropes to advanced therapies like mechanical circulatory support or transplantation.

Finally, nitrates and cytoprotective drugs continue to play a pivotal role in reducing myocardial oxygen demand and improving coronary perfusion. Understanding nitrate pharmacokinetics, dosing, and tolerance prevention enhances their clinical effectiveness while minimizing adverse effects.

By integrating modern diagnostic tools, pharmacological innovations, and patient-centered care strategies, clinicians can effectively manage cardiovascular diseases while improving quality of life and long-term prognosis. This review underscores the importance of a holistic, evidence-based approach to cardiovascular medicine—one that bridges pathophysiology with compassionate clinical practice