Unstable Angina and MI

  • Unstable Angina and MI
    • Diagnostic studies
      • Detailed health history
      • 12-lead ECG
        • Compare to previous ECG
        • Changes in QRS complex, ST segment, and T wave
        • Distinguish between STEMI and NSTEMI
        • Serial ECGs reflect evolution of MI
      • Coronary angiography
        • For patients with a STEMI
        • Not for patients with UA or NSTEMI
      • Pharmacologic stress testing
        • For patients with abnormal but non-diagnostic ECG and negative biomarkers
  • Interprofessional care
    • Acute Coronary Syndrome
      • Initial interventions
        • 12-lead ECG
        • Upright position
        • Oxygen – keep O2 sat > 93%
        • IV access
        • Nitroglycerin (SL) and ASA (chewable)
        • Statin
        • Morphine
      • Ongoing monitoring
        • Treat dysrhythmias
        • Frequent vital sign monitoring
        • Bed rest/limited activity for 12–24 hours
      • UA or NSTEMI
        • Dual antiplatelet therapy and heparin
        • Cardiac catheterization with PCI once stable
      • NSTEMI
        • Reperfusion therapy