acute%20coronary%20syndromes%20w_out%20persistent%20st-segment%20elevation
ACUTE CORONARY SYNDROMES W/OUT PERSISTENT ST-SEGMENT ELEVATION
Acute coronary syndromes refer to any constellation of clinical symptoms compatible with acute myocardial ischemia which may be life-threatening.
It encompasses unstable angina, non-ST-segment elevation myocardial infarction (NSTEMI) and ST-segment elevation myocardial infarction (STEMI).
Unstable angina is the ischemic discomfort that presents without persistent ST-segment elevation on ECG and without the presence of cardiac markers in the blood.
Non-ST-segment elevation myocardial infarction is diagnosed if cardiac markers are positive with ST-segment depression or with nonspecific or normal ECGs.
The patient typically presents with ischemic-type chest pain that is severe and prolonged and may occur at rest or may be caused by less exertion than previous episodes.

Supportive Therapy

Bed Rest

  • Usually prescribed initially in patients with UA/NSTEMI while ischemia is ongoing
    • Patient can be mobilized to bedside commode or chair when symptom-free
  • Ambulation as tolerated may begin once patient has been hemodynamically stable without recurrent symptoms for 12-24 hours
    • Subsequent activity should not be inappropriately restricted
    • Focus should be on the prevention of recurrent symptoms and activity may be increased once patient responds to therapy

Supplemental O2

  • Give supplemental O2 to all patients with overt pulmonary congestion or arterial O2 saturation <90% or respiratory distress or other high-risk features of hypoxemia
  • Consider in all patients with ACS for the 1st 6 hours of therapy
Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS Cardiology - Malaysia digital copy today!
Sign In To Download
Editor's Recommendations
Most Read Articles
4 days ago
A recent study has shown no improvement in the rate of blood pressure (BP) control despite an increase in the prevalence of antihypertensive medication use.
Roshini Claire Anthony, 11 Feb 2020

The consumption of processed meat or unprocessed red meat may be associated with a slightly elevated risk of incident cardiovascular disease (CVD)* and all-cause mortality, according to a US study.

29 Jan 2020
Several high-density lipoprotein (HDL) functionality parameters, which are linked to HDL roles on cholesterol metabolism, endothelial protection and antioxidant/anti-inflammatory defence, contribute to an increased risk of incident acute coronary syndromes and its manifestations in individuals at high risk of cardiovascular disease, a study reports.
Jairia Dela Cruz, 25 Nov 2019
Use of the PCSK9* inhibitor alirocumab in acute coronary syndrome (ACS) patients on a background of high-intensity statin treatment delivers reductions in total hospitalizations and death with corresponding gains in days alive and out of hospital (DAOH), according to the results of prespecified and posthoc analyses of the ODYSSEY OUTCOMES** trial presented at the American Heart Association (AHA) 2019 Scientific Sessions.