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2.1 Acute coronary syndrome: STEMI and NSTEMI
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Published:April 2019
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This version:December 2020
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Abstract
Management of acute coronary syndrome (ACS) is dictated by clinical features and electrocardiographic findings. Morphine is used for pain relief. Sublingual or intravenous nitrates are administered to relieve ischaemia. Patients should be treated with dual antiplatelet medications, usually aspirin and one of clopidogrel, prasugrel, or ticagrelor. For ST-segment elevation myocardial infarction, reperfusion therapy is with primary percutaneous coronary intervention (PPCI) or thrombolysis for those presenting to non-PPCI centres who cannot have timely access to PPCI. For non-ST-segment elevation myocardial infarction and unstable angina, timing of angiography, and revascularization if indicated, is determined by the severity of ischaemia. All patients with ACS should be treated with secondary prevention medications, including antiplatelet therapy, statins, beta-blockers, and renin–angiotensin system inhibitors.
Update:
Chapter updated to include the latest 2020 ESC Guidelines for the management of acute coronary syndromes in patients presenting without ...More
Update:
Chapter updated to include the latest 2020 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation
Four new figures and two new tables included in the chapter
References and Further reading also updated
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