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ACUTE CORONARY SYNDROME-SUMMARY OF MANAGEMENT

Cardiology

ACUTE CORONARY SYNDROME-SUMMARY OF MANAGEMENT

1. Inx and directed history.

2. High-risk features: ongoing chest pain > 20 min, reversible ST-segment changes > 0.5 mm, elevated cardiac enzymes, signs of LV dysfunction.

3. If the ECG is non-diagnostic: repeat the ECG q15-30 minutes or do continuous monitoring.

4. Possible ACS with non-diagnostic ECG and normal initial serum markers (Figure 5-2): observe 12hrs. If there is no recurrence & 2nd set of markers is negative, perform further risk stratification with a stress test.

5. Definitive ACS: if there is ST-segment elevation or new LBBB, consider emergent reperfusion.


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REFERENCES

1. Wilkinson, I. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press.
2. Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
3. Image: no reference available.

Ⓒ A. Manickam 2018

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