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Acute coronary syndrome: STEMI and NSTEMI 

Acute coronary syndrome: STEMI and NSTEMI
Chapter:
Acute coronary syndrome: STEMI and NSTEMI
Author(s):

Abhiram Prasad

, and Claire Raphael

DOI:
10.1093/med/9780198759935.003.0005
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date: 20 October 2019

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 loaded 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.

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