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== '''[[Acute coronary syndrome]]''' ==
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In [[medicine]] and [[cardiology]], '''acute coronary syndrome''' (ACS) is a collection of [[sign (medical)|signs]] and [[symptom]]s due to inadequate oxygenation of the heart muscle, the [[myocardium]], usually due to [[coronary artery disease]].<ref>{{MeSH}}</ref> ACS includes [[myocardial infarction]] ("heart attack") and  [[angina]].
==Footnotes==
 
Pain relief and proper oxygenation is the core of ACS treatment. When the root causie is angina, the temporary cause of ischemia should be reversed. For myocardial infarction, more vigorous interventions are appropriate if they can prevent damage to myocardium.
 
===Etiology/causes===
====Atheroclerotic obstruction====
ACS is usually caused by obstruction in an epicardial coronary artery.<ref name="pmid18687244">{{cite journal |author=Ong P, Athanasiadis A, Hill S, Vogelsberg H, Voehringer M, Sechtem U |title=Coronary artery spasm as a frequent cause of acute coronary syndrome: The CASPAR (Coronary Artery Spasm in Patients With Acute Coronary Syndrome) Study |journal=J. Am. Coll. Cardiol. |volume=52 |issue=7 |pages=523–7 |year=2008 |month=August |pmid=18687244 |doi=10.1016/j.jacc.2008.04.050 |url=http://linkinghub.elsevier.com/retrieve/pii/S0735-1097(08)01872-X |issn=}}</ref> The obstruction may be due to a thrombus at the site of a ruptured atherosclerotic plaque.<ref name="pmid1728732">{{cite journal |author=Mizuno K, Satomura K, Miyamoto A, ''et al'' |title=Angioscopic evaluation of coronary-artery thrombi in acute coronary syndromes |journal=N. Engl. J. Med. |volume=326 |issue=5 |pages=287–91 |year=1992 |month=January |pmid=1728732 |doi= |url= |issn=}}</ref>
 
Rupture seems more likely to occur during the morning hours.<ref name="pmid2865677">{{cite journal |author=Muller JE, Stone PH, Turi ZG, ''et al'' |title=Circadian variation in the frequency of onset of acute myocardial infarction |journal=N. Engl. J. Med. |volume=313 |issue=21 |pages=1315–22 |year=1985 |month=November |pmid=2865677 |doi= |url= |issn=}}</ref> Rupture may be precipited by inflammation from non-cardiac infections.<ref name="pmid18293142">{{cite journal |author=Harskamp RE, van Ginkel MW |title=Acute respiratory tract infections: a potential trigger for the acute coronary syndrome |journal=Ann. Med. |volume=40 |issue=2 |pages=121–8 |year=2008 |pmid=18293142 |doi=10.1080/07853890701753672 |url=http://www.informaworld.com/openurl?genre=article&doi=10.1080/07853890701753672&magic=pubmed&#124;&#124;1B69BA326FFE69C3F0A8F227DF8201D0 |issn=}}</ref> Rupture may be triggered by vigorous exercise among individuals who do not ordinarily do vigorous exercise.<ref name="pmid6472399">{{cite journal |author=Siscovick DS, Weiss NS, Fletcher RH, Lasky T |title=The incidence of primary cardiac arrest during vigorous exercise |journal=N. Engl. J. Med. |volume=311 |issue=14 |pages=874–7 |year=1984 |month=October |pmid=6472399 |doi= |url= |issn=}}</ref>
 
====Coronary vasospasm====
Approximately 15% of NSTEMI and 2% of STEMI patients have no obstruction of coronary vessels and in about half of these patients, spasm can be induced of a coronary artery.<ref name="pmid18687244"/>
 
''[[Acute coronary syndrome|.... (read more)]]''
 
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Latest revision as of 10:19, 11 September 2020

After decades of failure to slow the rising global consumption of coal, oil and gas,[1] many countries have proceeded as of 2024 to reconsider nuclear power in order to lower the demand for fossil fuels.[2] Wind and solar power alone, without large-scale storage for these intermittent sources, are unlikely to meet the world's needs for reliable energy.[3][4][5] See Figures 1 and 2 on the magnitude of the world energy challenge.

Nuclear power plants that use nuclear reactors to create electricity could provide the abundant, zero-carbon, dispatchable[6] energy needed for a low-carbon future, but not by simply building more of what we already have. New innovative designs for nuclear reactors are needed to avoid the problems of the past.

(CC) Image: Geoff Russell
Fig.1 Electricity consumption may soon double, mostly from coal-fired power plants in the developing world.[7]

Issues Confronting the Nuclear Industry

New reactor designers have sought to address issues that have prevented the acceptance of nuclear power, including safety, waste management, weapons proliferation, and cost. This article will summarize the questions that have been raised and the criteria that have been established for evaluating these designs. Answers to these questions will be provided by the designers of these reactors in the articles on their designs. Further debate will be provided in the Discussion and the Debate Guide pages of those articles.

Footnotes
  1. ↑ Global Energy Growth by Our World In Data
  2. ↑ Public figures who have reconsidered their stance on nuclear power are listed on the External Links tab of this article.
  3. ↑ Pumped storage is currently the most economical way to store electricity, but it requires a large reservoir on a nearby hill or in an abandoned mine. Li-ion battery systems at $500 per KWh are not practical for utility-scale storage. See Energy Storage for a summary of other alternatives.
  4. ↑ Utilities that include wind and solar power in their grid must have non-intermittent generating capacity (typically fossil fuels) to handle maximum demand for several days. They can save on fuel, but the cost of the plant is the same with or without intermittent sources.
  5. ↑ Mark Jacobson believes that long-distance transmission lines can provide an alternative to costly storage. See the bibliography for more on this proposal and the critique by Christopher Clack.
  6. ↑ "Load following" is the term used by utilities, and is important when there is a lot of wind and solar on the grid. Some reactors are not able to do this.
  7. ↑ Fig.1.3 in Devanney "Why Nuclear Power has been a Flop"

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