Management of non-STEMI and suspected acute coronary syndrome

Abstract

Patients presenting with acute coronary syndromes represent a diverse groups of patients and are at high risk of subsequent events. Patients with ST elevation require rapid triage for thrombolysis or primary angioplasty. Many of the remaining patients will also require inpatient coronary angiography and revascularisation by PCI or CABG. Risk stratification is performed on the basis of the ECG, cardiac enzymes and other high risk features. Patients without these high risk features may be first investigated with noninvasive tests for coronary ischaemia. All patients with suspected or confirmed ACS should be treated with a number of pharmacological agents, many of which will be continued longterm if coronary artery disease is detected to reduce subsequent events. Diagnosis, triage and treatment of these patients requires the collaboration of many different teams to achieve optimal results. © 2009 Rila Publications Ltd.