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
Stephen Padilla, 06 Aug 2020
The novel coronavirus disease (COVID-19) pandemic appears to have a significant impact on oncological care, according to a study, which stresses the need for psycho-oncological support for cancer patients.
01 Aug 2020
Supplementation with probiotics may have positive effects in patients with type 2 diabetes mellitus (T2DM), reports a recent meta-analysis.
06 Aug 2020
Sodium–glucose cotransporter-2 (SGLT-2) inhibitors increase the risk for diabetic ketoacidosis (DKA) by almost threefold, with molecule-specific analyses suggesting a class effect, according to a study.
Stephen Padilla, 3 days ago
Pre-exposure prophylaxis (PrEP) containing either long-acting injectable cabotegravir (CAB) or tenofovir/emtricitabine (TDF/FTC) is safe and effective for transgender women (TGW) and cisgender men who have sex with men (MSM), but CAB results in a much lower HIV incidence compared to TDF/FTC, results of the HIV Prevention Trials Network (HPTN) 083 have shown.