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Abstract
The Worled Health Organization (WHO) estimated that in 2002, 12.6% of deaths worldwide were from ischemic heart disease. Ischemic heart disease is the leading cause of death in developed countries, but third to AIDS and lower respiratory infections in developing countries Myocardial ischemia is most often due to atherosclerotic plaques which reduce the blood supply to a portion of myocardium One of the most powerful manifestations of atherosclerosis is acute coronary syndrome. Acute coronary syndrome (ACS) is an endpoint of atherosclerosis Acute coronary syndrome (ACS) is a term used to describe a group of conditions, ranging from unstable angina to acute myocardial infarction, in patients with ischemic heart disease Coronary heart disease (CHD) is more common in men than women. Gender differences in CHD risk may be explained by a different impact that coronary risk factors may have for men and women, in the development of CHD Women have their first cardiac event 6 to 10 years later than men do. whereas the cardiovascular death rates are declining in men, they remain constant in women. Women have excessive mortality rates after acute myocardial infarction compared with men Diagnosis of acute coronary syndrome ( to be differentiated from other causes of acute chest pain) requires focused history including the risk factors analysis, physical examination, ECG, and serum level of the cardiac biomarkers.