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Scott Weingart. EMCrit RACC Podcast 217 – The Ultimate “Ultimate” BVM. EMCrit Blog. Published on February 5, 2018. Available at [https://emcrit.org/racc/ultimate-bvm/ ]

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domingo, 31 de julio de 2016

ED management of NSTEMI

emDocs - July 30, 2016 - Authors: Kapoor S and Zeserson E 
Edited by: Santistevan J,  Long B and Koyfman A
  • A completely normal ECG does not exclude ACS and occurs in 1-6% of patients.
  • Repeat ECGs can be helpful in making the diagnosis of NSTE-ACS and should be used liberally.
  • Troponin levels should be repeated at least 3-6 hours after symptom onset.
  • Relief of chest pain with nitroglycerin cannot rule in or out NSTE-ACS.
  • After diagnosis of NSTE-ACS risk-stratification is helpful to guide further management.
  • Consider ECG changes and troponin levels along with initial presentation when risk-stratifying patients.
  • Atypical symptoms such as weakness and nausea should not exclude NSTE-ACS from differential diagnosis, especially in the elderly, diabetics and women.
  • Available data suggests that patients with troponin elevations at time of diagnosis of NSTE-ACS will benefit from early-invasive treatment."