Professional Documents
Culture Documents
4 6039601780642285285
4 6039601780642285285
syndromes
DEFINITIONS
[----UA---------NSTEMI----------STEMI----]
Unstable
NSTEMI STEMI
Angina
Non-occlusive
thrombus Complete thrombus
Non occlusive sufficient to cause occlusion
thrombus tissue damage & mild
myocardial necrosis ST elevations on
Non specific ECG or new LBBB
ECG ST depression +/-
T wave inversion on Elevated cardiac
Normal cardiac ECG enzymes
enzymes
Elevated cardiac More severe
enzymes symptoms
PATHOPHYSIOLOGY
• The discomfort may radiate to the shoulder, down the left arm,
to the back, or to the jaw
Is a "clinical syndrome
characterized by discomfort in
the chest, jaw, shoulder, back, or
arm"
8
Diagnosis of ACS
• At least 2 of the following
• troponin I or T, CK-MB
• metoprolol
• Beta Blocker Heart Attack Trial (propranolol)
• Esmolol vs. placebo
• Carvedilol vs. placebo
• Propranolol vs. placebo
– Overall, treatment with beta blockers reduces primary
endpoints when compared to placebo
AHA/ACC Guidelines for Beta Blocker Therapy
• ECG changes
TIMI Risk Score