Podcast
Questions and Answers
Which symptom is most common for patients with Acute Coronary Syndromes (ACS)?
Which symptom is most common for patients with Acute Coronary Syndromes (ACS)?
- Shortness of breath
- Chest pain (correct)
- Nausea
- Back pain
What are important elements to consider in the history of patients with ACS?
What are important elements to consider in the history of patients with ACS?
- Recent diet, exercise, and sleep patterns
- Previous medical history of the patient's family
- Blood pressure, heart rate, and respiratory rate
- Timing of symptom onset, location, quality, severity, and duration (correct)
Which risk factor is associated with accelerated coronary artery disease (CAD) development?
Which risk factor is associated with accelerated coronary artery disease (CAD) development?
- Family history of CAD
- High cholesterol levels
- Long history of cocaine use (correct)
- Older age
What percentage of patients diagnosed with ACS report atypical symptoms?
What percentage of patients diagnosed with ACS report atypical symptoms?
Which of the following is not a typical atypical symptom of ACS?
Which of the following is not a typical atypical symptom of ACS?
What is a clinical feature associated with chest pain diagnosed as ACS?
What is a clinical feature associated with chest pain diagnosed as ACS?
What should be discussed with patients to stratify the risk of ACS?
What should be discussed with patients to stratify the risk of ACS?
What is a risk factor for coronary artery disease (CAD) that can lead to ACS?
What is a risk factor for coronary artery disease (CAD) that can lead to ACS?
What type of chest pain is associated with ACS?
What type of chest pain is associated with ACS?
What can recent cocaine use cause in relation to ACS?
What can recent cocaine use cause in relation to ACS?
Which anticoagulant is preferred for patients in whom CABG is planned?
Which anticoagulant is preferred for patients in whom CABG is planned?
Which antithrombin is considered an option for patients with unstable angina or NSTEMI?
Which antithrombin is considered an option for patients with unstable angina or NSTEMI?
Which anticoagulant may be considered for STEMI patients lacking renal impairment and treated with non-fibrin specific thrombolytics?
Which anticoagulant may be considered for STEMI patients lacking renal impairment and treated with non-fibrin specific thrombolytics?
Which direct thrombin inhibitor is resistant to agents that degrade heparin?
Which direct thrombin inhibitor is resistant to agents that degrade heparin?
Which antiplatelet agent is not listed in the given text?
Which antiplatelet agent is not listed in the given text?
Which fibrinolytic agent is not listed in the given text?
Which fibrinolytic agent is not listed in the given text?
What is the loading dose of aspirin for emergency treatment of STEMI?
What is the loading dose of aspirin for emergency treatment of STEMI?
What is the loading dose of clopidogrel for emergency treatment of STEMI?
What is the loading dose of clopidogrel for emergency treatment of STEMI?
What is the loading dose of prasugrel for emergency treatment of STEMI?
What is the loading dose of prasugrel for emergency treatment of STEMI?
What is the loading dose of ticagrelor for emergency treatment of STEMI?
What is the loading dose of ticagrelor for emergency treatment of STEMI?
What is the essential initial step for assessing signs of cardiac ischemia in patients with acute symptoms?
What is the essential initial step for assessing signs of cardiac ischemia in patients with acute symptoms?
Which finding is diagnostic for ST-segment elevation myocardial infarction (STEMI)?
Which finding is diagnostic for ST-segment elevation myocardial infarction (STEMI)?
How is non-ST-segment elevation myocardial infarction (NSTEMI) diagnosed?
How is non-ST-segment elevation myocardial infarction (NSTEMI) diagnosed?
What is the characteristic presentation of unstable angina?
What is the characteristic presentation of unstable angina?
What is the recommended initial treatment for patients with suspected Acute Coronary Syndrome (ACS)?
What is the recommended initial treatment for patients with suspected Acute Coronary Syndrome (ACS)?
What is the primary goal of STEMI treatment?
What is the primary goal of STEMI treatment?
When is clopidogrel recommended for use in patients with ACS?
When is clopidogrel recommended for use in patients with ACS?
What adjunct therapy may be considered for ongoing angina in ACS patients?
What adjunct therapy may be considered for ongoing angina in ACS patients?
What can physical examination help identify in patients with acute symptoms?
What can physical examination help identify in patients with acute symptoms?
What is the role of risk factors in predicting myocardial infarction in patients with acute symptoms?
What is the role of risk factors in predicting myocardial infarction in patients with acute symptoms?
What percentage of patients diagnosed with ACS report atypical symptoms?
What percentage of patients diagnosed with ACS report atypical symptoms?
Which of the following is a risk factor for accelerated coronary artery disease (CAD) development?
Which of the following is a risk factor for accelerated coronary artery disease (CAD) development?
What is a key clinical feature associated with chest pain diagnosed as ACS?
What is a key clinical feature associated with chest pain diagnosed as ACS?
Which risk factor should be discussed with patients to stratify the risk of ACS?
Which risk factor should be discussed with patients to stratify the risk of ACS?
What is a symptom commonly reported by patients with ACS?
What is a symptom commonly reported by patients with ACS?
What is a characteristic presentation of unstable angina?
What is a characteristic presentation of unstable angina?
Which of the following is a risk factor for coronary artery disease (CAD) that can lead to ACS?
Which of the following is a risk factor for coronary artery disease (CAD) that can lead to ACS?
What are important elements to consider in the history of patients with ACS?
What are important elements to consider in the history of patients with ACS?
What adjunct therapy may be considered for ongoing angina in ACS patients?
What adjunct therapy may be considered for ongoing angina in ACS patients?
What is the primary goal of STEMI treatment?
What is the primary goal of STEMI treatment?
Which anticoagulant is preferred for patients in whom CABG is planned?
Which anticoagulant is preferred for patients in whom CABG is planned?
Which antithrombin is considered an option for patients with unstable angina or NSTEMI?
Which antithrombin is considered an option for patients with unstable angina or NSTEMI?
Which direct thrombin inhibitor is resistant to agents that degrade heparin?
Which direct thrombin inhibitor is resistant to agents that degrade heparin?
What is the loading dose of Ticagrelor for emergency treatment of STEMI?
What is the loading dose of Ticagrelor for emergency treatment of STEMI?
What is the loading dose of ticagrelor for emergency treatment of STEMI?
What is the loading dose of ticagrelor for emergency treatment of STEMI?
What adjunct therapy may be considered for ongoing angina in ACS patients?
What adjunct therapy may be considered for ongoing angina in ACS patients?
What percentage of patients diagnosed with ACS report atypical symptoms?
What percentage of patients diagnosed with ACS report atypical symptoms?
What is the role of risk factors in predicting myocardial infarction in patients with acute symptoms?
What is the role of risk factors in predicting myocardial infarction in patients with acute symptoms?
What can recent cocaine use cause in relation to ACS?
What can recent cocaine use cause in relation to ACS?
What is the diagnostic criteria for NSTEMI?
What is the diagnostic criteria for NSTEMI?
What is the characteristic presentation of unstable angina?
What is the characteristic presentation of unstable angina?
What is the primary goal of STEMI treatment?
What is the primary goal of STEMI treatment?
What is the initial step for assessing signs of cardiac ischemia in patients with acute symptoms?
What is the initial step for assessing signs of cardiac ischemia in patients with acute symptoms?
Which adjunct therapy may be considered for ongoing angina in ACS patients?
Which adjunct therapy may be considered for ongoing angina in ACS patients?
When is clopidogrel recommended for use in patients with moderate to high-risk NSTEMI and STEMI?
When is clopidogrel recommended for use in patients with moderate to high-risk NSTEMI and STEMI?
What is the role of risk factors in predicting myocardial infarction in patients with acute symptoms?
What is the role of risk factors in predicting myocardial infarction in patients with acute symptoms?
What is the recommended initial treatment for patients with suspected Acute Coronary Syndrome (ACS)?
What is the recommended initial treatment for patients with suspected Acute Coronary Syndrome (ACS)?
Which anticoagulant may be considered for STEMI patients lacking renal impairment and treated with non-fibrin specific thrombolytics?
Which anticoagulant may be considered for STEMI patients lacking renal impairment and treated with non-fibrin specific thrombolytics?
What adjunct therapy is recommended for ongoing angina in ACS patients?
What adjunct therapy is recommended for ongoing angina in ACS patients?
Which anticoagulant is preferred for patients in whom CABG is planned?
Which anticoagulant is preferred for patients in whom CABG is planned?
What is the loading dose of ticagrelor for emergency treatment of STEMI?
What is the loading dose of ticagrelor for emergency treatment of STEMI?
Which direct thrombin inhibitor is resistant to agents that degrade heparin?
Which direct thrombin inhibitor is resistant to agents that degrade heparin?
What is the role of risk factors in predicting myocardial infarction in patients with acute symptoms?
What is the role of risk factors in predicting myocardial infarction in patients with acute symptoms?
When is clopidogrel recommended for use in patients with moderate to high-risk NSTEMI and STEMI?
When is clopidogrel recommended for use in patients with moderate to high-risk NSTEMI and STEMI?
What is the loading dose of prasugrel for emergency treatment of STEMI?
What is the loading dose of prasugrel for emergency treatment of STEMI?
Which antiplatelet agent is not listed in the given text?
Which antiplatelet agent is not listed in the given text?
What adjunct therapy may be considered for ongoing angina in ACS patients?
What adjunct therapy may be considered for ongoing angina in ACS patients?
Which antiplatelet agent has a loading dose of 600 mg PO followed by 75 mg/d?
Which antiplatelet agent has a loading dose of 600 mg PO followed by 75 mg/d?
What is the loading dose of clopidogrel for emergency treatment of STEMI?
What is the loading dose of clopidogrel for emergency treatment of STEMI?
What is the percentage of patients diagnosed with ACS that report atypical symptoms?
What is the percentage of patients diagnosed with ACS that report atypical symptoms?
What is the recommended initial treatment for patients with suspected Acute Coronary Syndrome (ACS)?
What is the recommended initial treatment for patients with suspected Acute Coronary Syndrome (ACS)?
Which risk factor is associated with accelerated coronary artery disease (CAD) development?
Which risk factor is associated with accelerated coronary artery disease (CAD) development?
What is the role of risk factors in predicting myocardial infarction in patients with acute symptoms?
What is the role of risk factors in predicting myocardial infarction in patients with acute symptoms?
Which of the following is a diagnostic criterion for ST-segment elevation myocardial infarction (STEMI)?
Which of the following is a diagnostic criterion for ST-segment elevation myocardial infarction (STEMI)?
What adjunct therapy may be considered for ongoing angina in ACS patients?
What adjunct therapy may be considered for ongoing angina in ACS patients?
What is the recommended initial treatment for patients with suspected Acute Coronary Syndrome (ACS)?
What is the recommended initial treatment for patients with suspected Acute Coronary Syndrome (ACS)?
Which anticoagulant is preferred for patients in whom CABG is planned?
Which anticoagulant is preferred for patients in whom CABG is planned?
Which adjunct therapy may be considered for ongoing angina in ACS patients?
Which adjunct therapy may be considered for ongoing angina in ACS patients?
What can recent cocaine use cause in relation to ACS?
What can recent cocaine use cause in relation to ACS?
What is the characteristic presentation of unstable angina?
What is the characteristic presentation of unstable angina?
What is the characteristic presentation of unstable angina?
What is the characteristic presentation of unstable angina?
When is clopidogrel recommended for use in patients with moderate to high-risk NSTEMI and STEMI?
When is clopidogrel recommended for use in patients with moderate to high-risk NSTEMI and STEMI?
What adjunct therapy is recommended for ongoing angina in ACS patients?
What adjunct therapy is recommended for ongoing angina in ACS patients?
What is the primary goal of STEMI treatment?
What is the primary goal of STEMI treatment?
What should be discussed with patients to stratify the risk of ACS?
What should be discussed with patients to stratify the risk of ACS?
How is non-ST-segment elevation myocardial infarction (NSTEMI) diagnosed?
How is non-ST-segment elevation myocardial infarction (NSTEMI) diagnosed?
Which anticoagulant is considered an option for patients with unstable angina or NSTEMI?
Which anticoagulant is considered an option for patients with unstable angina or NSTEMI?
What can recent cocaine use cause in relation to ACS?
What can recent cocaine use cause in relation to ACS?
Which antithrombin is considered an option for patients with unstable angina or NSTEMI?
Which antithrombin is considered an option for patients with unstable angina or NSTEMI?
Match the following clinical features with their association with chest pain in ACS:
Match the following clinical features with their association with chest pain in ACS:
Match the following risk factors for coronary artery disease (CAD) with their association with ACS:
Match the following risk factors for coronary artery disease (CAD) with their association with ACS:
Match the following atypical symptoms with their association in ACS diagnosis:
Match the following atypical symptoms with their association in ACS diagnosis:
Match the following risk factors for coronary artery disease (CAD) with their association with ACS:
Match the following risk factors for coronary artery disease (CAD) with their association with ACS:
Match the following risk factors for coronary artery disease (CAD) with their association with ACS:
Match the following risk factors for coronary artery disease (CAD) with their association with ACS:
Match the following diagnostic tool with its essential role in ACS diagnosis:
Match the following diagnostic tool with its essential role in ACS diagnosis:
Match the following diagnoses with the alternative conditions for patient symptoms:
Match the following diagnoses with the alternative conditions for patient symptoms:
Match the following ACS types with their diagnostic criteria:
Match the following ACS types with their diagnostic criteria:
Match the following treatment options with their respective use in ACS management:
Match the following treatment options with their respective use in ACS management:
Match the following initial management steps with their recommended actions for patients with suspected ACS:
Match the following initial management steps with their recommended actions for patients with suspected ACS:
Match the following anticoagulants with their recommended use in patients with unstable angina or NSTEMI:
Match the following anticoagulants with their recommended use in patients with unstable angina or NSTEMI:
Match the following anticoagulants with their use in patients undergoing PCI revascularization:
Match the following anticoagulants with their use in patients undergoing PCI revascularization:
Match the following anticoagulants with their use in STEMI patients lacking renal impairment:
Match the following anticoagulants with their use in STEMI patients lacking renal impairment:
Match the following anticoagulants with their resistance to agents that degrade heparin:
Match the following anticoagulants with their resistance to agents that degrade heparin:
Match the following antiplatelet agents with their use in emergency treatment of STEMI:
Match the following antiplatelet agents with their use in emergency treatment of STEMI:
Match the following antithrombins with their use in emergency treatment of STEMI:
Match the following antithrombins with their use in emergency treatment of STEMI:
Match the following fibrinolytic agents with their use in emergency treatment of STEMI:
Match the following fibrinolytic agents with their use in emergency treatment of STEMI:
Match the following glycoprotein IIb/IIIa inhibitors with their use in emergency treatment of STEMI:
Match the following glycoprotein IIb/IIIa inhibitors with their use in emergency treatment of STEMI:
Match the following anti-ischemic therapies with their use in emergency treatment of STEMI:
Match the following anti-ischemic therapies with their use in emergency treatment of STEMI:
Match the following adjunct therapies with their use for ongoing angina in ACS patients:
Match the following adjunct therapies with their use for ongoing angina in ACS patients:
Patients with ACS may present with atypical symptoms, such as shortness of breath or abdominal pain.
Patients with ACS may present with atypical symptoms, such as shortness of breath or abdominal pain.
Chest pain is the only symptom reported by patients with ACS.
Chest pain is the only symptom reported by patients with ACS.
Patients with a long history of cocaine use are not at risk for accelerated CAD development.
Patients with a long history of cocaine use are not at risk for accelerated CAD development.
Important elements of the history for patients with ACS include the timing, location, quality, severity, and duration of chest pain.
Important elements of the history for patients with ACS include the timing, location, quality, severity, and duration of chest pain.
Recent cocaine use can cause acute ischemia from coronary vasospasm.
Recent cocaine use can cause acute ischemia from coronary vasospasm.
Atypical symptoms of ACS can include dizziness and palpitations.
Atypical symptoms of ACS can include dizziness and palpitations.
The risk factors for CAD, such as older age and smoking, are not important in stratifying the risk of ACS.
The risk factors for CAD, such as older age and smoking, are not important in stratifying the risk of ACS.
The most common symptom for patients with ACS is substernal or left-sided chest pain.
The most common symptom for patients with ACS is substernal or left-sided chest pain.
Patients diagnosed with ACS may not report chest pain as their chief complaint.
Patients diagnosed with ACS may not report chest pain as their chief complaint.
Nausea, vomiting, or diaphoresis are not associated with chest pain diagnosed as ACS.
Nausea, vomiting, or diaphoresis are not associated with chest pain diagnosed as ACS.
Unfractionated heparin is the preferred anticoagulant for patients in whom CABG is planned.
Unfractionated heparin is the preferred anticoagulant for patients in whom CABG is planned.
Fondaparinux is considered an option as an antithrombin in patients with unstable angina or NSTEMI.
Fondaparinux is considered an option as an antithrombin in patients with unstable angina or NSTEMI.
Fondaparinux may be considered for STEMI patients treated with non-fibrin specific thrombolytics such as streptokinase.
Fondaparinux may be considered for STEMI patients treated with non-fibrin specific thrombolytics such as streptokinase.
Direct thrombin inhibitors, such as bivalirudin, have been found to have better outcomes than unfractionated heparin.
Direct thrombin inhibitors, such as bivalirudin, have been found to have better outcomes than unfractionated heparin.
Aspirin, clopidogrel, and ticagrelor are all listed as antiplatelet agents used in the emergency treatment of STEMI.
Aspirin, clopidogrel, and ticagrelor are all listed as antiplatelet agents used in the emergency treatment of STEMI.
Enoxaparin is a factor Xa inhibitor.
Enoxaparin is a factor Xa inhibitor.
The loading dose of aspirin for emergency treatment of STEMI is 162–325 mg.
The loading dose of aspirin for emergency treatment of STEMI is 162–325 mg.
Prasugrel has a loading dose of 180 mg followed by 90 mg twice a day for emergency treatment of STEMI.
Prasugrel has a loading dose of 180 mg followed by 90 mg twice a day for emergency treatment of STEMI.
Abciximab, eptifibatide, and tirofiban are all listed as glycoprotein IIb/IIIa inhibitors used in the emergency treatment of STEMI.
Abciximab, eptifibatide, and tirofiban are all listed as glycoprotein IIb/IIIa inhibitors used in the emergency treatment of STEMI.
The recommended initial treatment for patients with suspected Acute Coronary Syndrome (ACS) includes administering a loading dose of 600 mg PO followed by 75 mg/d of clopidogrel.
The recommended initial treatment for patients with suspected Acute Coronary Syndrome (ACS) includes administering a loading dose of 600 mg PO followed by 75 mg/d of clopidogrel.
Risk factors alone are highly predictive of myocardial infarction in patients with acute symptoms
Risk factors alone are highly predictive of myocardial infarction in patients with acute symptoms
Unstable angina is primarily diagnosed based on diagnostic testing
Unstable angina is primarily diagnosed based on diagnostic testing
Promptly obtaining an ECG is not essential to assess for signs of cardiac ischemia
Promptly obtaining an ECG is not essential to assess for signs of cardiac ischemia
NSTEMI is diagnosed solely based on elevated serum troponin levels
NSTEMI is diagnosed solely based on elevated serum troponin levels
Acute Coronary Syndromes may present with symptoms resembling pulmonary embolism
Acute Coronary Syndromes may present with symptoms resembling pulmonary embolism
ST-segment elevations in specific locations are diagnostic for NSTEMI
ST-segment elevations in specific locations are diagnostic for NSTEMI
Clopidogrel is not recommended for use in patients with moderate to high-risk NSTEMI and STEMI
Clopidogrel is not recommended for use in patients with moderate to high-risk NSTEMI and STEMI
Aspirin is not recommended as an initial treatment for patients with suspected ACS
Aspirin is not recommended as an initial treatment for patients with suspected ACS
Administering nitroglycerin and morphine sulfate is not recommended as adjuncts for ongoing angina in ACS patients
Administering nitroglycerin and morphine sulfate is not recommended as adjuncts for ongoing angina in ACS patients
Unstable angina is not characterized by chest pain associated with evidence of obstructive coronary artery disease
Unstable angina is not characterized by chest pain associated with evidence of obstructive coronary artery disease
Study Notes
Acute Coronary Syndromes: Diagnosis and Emergency Department Care
- Risk factors alone are not highly predictive of myocardial infarction in patients with acute symptoms
- Physical examination can help identify signs of hemodynamic dysfunction from cardiac strain or acute heart failure
- Alternative diagnoses for patient symptoms may include pulmonary embolism, congestive heart failure, and others
- Promptly obtaining an ECG is essential to assess for signs of cardiac ischemia
- Findings diagnostic for STEMI include specific criteria for ST-segment elevations in different locations
- NSTEMI is diagnosed when an elevated serum troponin is identified in a patient with symptoms consistent with myocardial ischemia
- Unstable angina is a clinical diagnosis based on history, physical examination findings, and diagnostic testing
- Unstable angina characteristically presents with chest pain associated with evidence of obstructive coronary artery disease
- STEMI treatment includes reperfusion by reducing thrombus, limiting thrombus extension, and relieving obstructive CAD
- For patients with a suspected ACS, begin cardiac monitoring, place an intravenous line, and provide supplemental oxygen if necessary
- Administer aspirin, consider nitroglycerin and morphine sulfate as adjuncts for ongoing angina
- Clopidogrel is recommended for use along with aspirin for patients with moderate to high-risk NSTEMI and STEMI
Acute Coronary Syndromes: Diagnosis and Emergency Department Care
- Risk factors alone are not highly predictive of myocardial infarction in patients with acute symptoms
- Physical examination can help identify signs of hemodynamic dysfunction from cardiac strain or acute heart failure
- Alternative diagnoses for patient symptoms may include pulmonary embolism, congestive heart failure, and others
- Promptly obtaining an ECG is essential to assess for signs of cardiac ischemia
- Findings diagnostic for STEMI include specific criteria for ST-segment elevations in different locations
- NSTEMI is diagnosed when an elevated serum troponin is identified in a patient with symptoms consistent with myocardial ischemia
- Unstable angina is a clinical diagnosis based on history, physical examination findings, and diagnostic testing
- Unstable angina characteristically presents with chest pain associated with evidence of obstructive coronary artery disease
- STEMI treatment includes reperfusion by reducing thrombus, limiting thrombus extension, and relieving obstructive CAD
- For patients with a suspected ACS, begin cardiac monitoring, place an intravenous line, and provide supplemental oxygen if necessary
- Administer aspirin, consider nitroglycerin and morphine sulfate as adjuncts for ongoing angina
- Clopidogrel is recommended for use along with aspirin for patients with moderate to high-risk NSTEMI and STEMI
Acute Coronary Syndromes: Diagnosis and Emergency Department Care
- Risk factors alone are not highly predictive of myocardial infarction in patients with acute symptoms
- Physical examination can help identify signs of hemodynamic dysfunction from cardiac strain or acute heart failure
- Alternative diagnoses for patient symptoms may include pulmonary embolism, congestive heart failure, and others
- Promptly obtaining an ECG is essential to assess for signs of cardiac ischemia
- Findings diagnostic for STEMI include specific criteria for ST-segment elevations in different locations
- NSTEMI is diagnosed when an elevated serum troponin is identified in a patient with symptoms consistent with myocardial ischemia
- Unstable angina is a clinical diagnosis based on history, physical examination findings, and diagnostic testing
- Unstable angina characteristically presents with chest pain associated with evidence of obstructive coronary artery disease
- STEMI treatment includes reperfusion by reducing thrombus, limiting thrombus extension, and relieving obstructive CAD
- For patients with a suspected ACS, begin cardiac monitoring, place an intravenous line, and provide supplemental oxygen if necessary
- Administer aspirin, consider nitroglycerin and morphine sulfate as adjuncts for ongoing angina
- Clopidogrel is recommended for use along with aspirin for patients with moderate to high-risk NSTEMI and STEMI
Acute Coronary Syndromes: Diagnosis and Emergency Department Care
- Risk factors alone are not highly predictive of myocardial infarction in patients with acute symptoms
- Physical examination can help identify signs of hemodynamic dysfunction from cardiac strain or acute heart failure
- Alternative diagnoses for patient symptoms may include pulmonary embolism, congestive heart failure, and others
- Promptly obtaining an ECG is essential to assess for signs of cardiac ischemia
- Findings diagnostic for STEMI include specific criteria for ST-segment elevations in different locations
- NSTEMI is diagnosed when an elevated serum troponin is identified in a patient with symptoms consistent with myocardial ischemia
- Unstable angina is a clinical diagnosis based on history, physical examination findings, and diagnostic testing
- Unstable angina characteristically presents with chest pain associated with evidence of obstructive coronary artery disease
- STEMI treatment includes reperfusion by reducing thrombus, limiting thrombus extension, and relieving obstructive CAD
- For patients with a suspected ACS, begin cardiac monitoring, place an intravenous line, and provide supplemental oxygen if necessary
- Administer aspirin, consider nitroglycerin and morphine sulfate as adjuncts for ongoing angina
- Clopidogrel is recommended for use along with aspirin for patients with moderate to high-risk NSTEMI and STEMI
Acute Coronary Syndromes: Diagnosis and Emergency Department Care
- Risk factors alone are not highly predictive of myocardial infarction in patients with acute symptoms
- Physical examination can help identify signs of hemodynamic dysfunction from cardiac strain or acute heart failure
- Alternative diagnoses for patient symptoms may include pulmonary embolism, congestive heart failure, and others
- Promptly obtaining an ECG is essential to assess for signs of cardiac ischemia
- Findings diagnostic for STEMI include specific criteria for ST-segment elevations in different locations
- NSTEMI is diagnosed when an elevated serum troponin is identified in a patient with symptoms consistent with myocardial ischemia
- Unstable angina is a clinical diagnosis based on history, physical examination findings, and diagnostic testing
- Unstable angina characteristically presents with chest pain associated with evidence of obstructive coronary artery disease
- STEMI treatment includes reperfusion by reducing thrombus, limiting thrombus extension, and relieving obstructive CAD
- For patients with a suspected ACS, begin cardiac monitoring, place an intravenous line, and provide supplemental oxygen if necessary
- Administer aspirin, consider nitroglycerin and morphine sulfate as adjuncts for ongoing angina
- Clopidogrel is recommended for use along with aspirin for patients with moderate to high-risk NSTEMI and STEMI
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Test your knowledge of acute coronary syndromes, including diagnosis and emergency department care. Challenge yourself with questions about risk factors, diagnostic tests, treatment options, and alternative diagnoses for patients with symptoms of myocardial infarction and unstable angina.
