Acute coronary syndrome (main): Difference between revisions
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*[[ECG (Diagnosis)]] | *[[ECG (Diagnosis)]] | ||
**ECG is normal in 8% of all confirmed MI's | **ECG is normal in 8% of all confirmed MI's | ||
**In LBBB see [[Sgarbossa's Criteria]] | **In [[LBBB]] see [[Sgarbossa's Criteria]] | ||
*[[Cardiac Enzymes]] | *[[Cardiac Enzymes]] | ||
*[[ACS - Risk Stratification]] | *[[ACS - Risk Stratification]] | ||
Revision as of 06:27, 5 February 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