Acute coronary syndrome (main): Difference between revisions
Ostermayer (talk | contribs) |
(added link to new page) |
||
Line 53: | Line 53: | ||
* [[NSTEMI]] | * [[NSTEMI]] | ||
* [[Unstable Angina]] | * [[Unstable Angina]] | ||
* [[Unstable Angina - NSTEMI Guidelines]] | |||
[[Category:Cards]] | [[Category:Cards]] |
Revision as of 21:01, 23 March 2014
Background
ACS is three diseases involving the coronary arteries:
- ST-Elevation Myocardial Infarction (STEMI) (30%)
- Non ST-Elevation Myocardial Infarction (NSTEMI) (25%)
- Unstable Angina (38%)
DDx
Diagnosis
Clinical factors that increase likelihood of ACS/AMI:
- Chest pain radiating both arms >R arm >L arm
- Chest pain associated with diaphoresis
- Chest pain associated with N/V
- Chest pain with exertion
Clinical factors that decrease likelihood of ACS/AMI:
- Pleuritic chest pain
- Positional chest pain
- Sharp, stabbing chest pain
- Chest pain reproducible with palpation
- ECG (Diagnosis)
- ECG is normal in 8% of all confirmed MI's
- In LBBB see Sgarbossa's Criteria
- Cardiac Enzymes
- ACS - Risk Stratification
- ACS - Anatomical Correlation
Treatment
Intensity of Rx should be based on likelihood that sx are due to acute coronary thombosis
- ST-Elevation Myocardial Infarction (STEMI)
- Non ST-Elevation Myocardial Infarction (NSTEMI)
- Unstable Angina
Disposition
- Admit all ACS pts