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
