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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

In computational molecular physics and solid state physics, the Born-Oppenheimer approximation is used to separate the quantum mechanical motion of the electrons from the motion of the nuclei. The method relies on the large mass ratio of electrons and nuclei. For instance the lightest nucleus, the hydrogen nucleus, is already 1836 times heavier than an electron. The method is named after Max Born and Robert Oppenheimer[1], who proposed it in 1927.

Rationale

The computation of the energy and wave function of an average-size molecule is a formidable task that is alleviated by the Born-Oppenheimer (BO) approximation.The BO approximation makes it possible to compute the wave function in two less formidable, consecutive, steps. This approximation was proposed in the early days of quantum mechanics by Born and Oppenheimer (1927) and is indispensable in quantum chemistry and ubiquitous in large parts of computational physics.

In the first step of the BO approximation the electronic Schrödinger equation is solved, yielding a wave function depending on electrons only. For benzene this wave function depends on 126 electronic coordinates. During this solution the nuclei are fixed in a certain configuration, very often the equilibrium configuration. If the effects of the quantum mechanical nuclear motion are to be studied, for instance because a vibrational spectrum is required, this electronic computation must be repeated for many different nuclear configurations. The set of electronic energies thus computed becomes a function of the nuclear coordinates. In the second step of the BO approximation this function serves as a potential in a Schrödinger equation containing only the nuclei—for benzene an equation in 36 variables.

The success of the BO approximation is due to the high ratio between nuclear and electronic masses. The approximation is an important tool of quantum chemistry, without it only the lightest molecule, H2, could be handled; all computations of molecular wave functions for larger molecules make use of it. Even in the cases where the BO approximation breaks down, it is used as a point of departure for the computations.

Historical note

The Born-Oppenheimer approximation is named after M. Born and R. Oppenheimer who wrote a paper [Annalen der Physik, vol. 84, pp. 457-484 (1927)] entitled: Zur Quantentheorie der Molekeln (On the Quantum Theory of Molecules). This paper describes the separation of electronic motion, nuclear vibrations, and molecular rotation. A reader of this paper who expects to find clearly delineated the BO approximation—as it is explained above and in most modern textbooks—will be disappointed. The presentation of the BO approximation is well hidden in Taylor expansions (in terms of internal and external nuclear coordinates) of (i) electronic wave functions, (ii) potential energy surfaces and (iii) nuclear kinetic energy terms. Internal coordinates are the relative positions of the nuclei in the molecular equilibrium and their displacements (vibrations) from equilibrium. External coordinates are the position of the center of mass and the orientation of the molecule. The Taylor expansions complicate the theory tremendously and make the derivations very hard to follow. Moreover, knowing that the proper separation of vibrations and rotations was not achieved in this work, but only eight years later [by C. Eckart, Physical Review, vol. 46, pp. 383-387 (1935)] (see Eckart conditions), chemists and molecular physicists are not very much motivated to invest much effort into understanding the work by Born and Oppenheimer, however famous it may be. Although the article still collects many citations each year, it is safe to say that it is not read anymore, except maybe by historians of science.

Footnotes

  1. Wikipedia has an article about Robert Oppenheimer.