MODULE B: Suspected Acute Coronary Syndrome (CS)
Patient with Definite/Probable Non-ST Elevation Acute Coronary Syndrome (ACS) [Unstable Angina (UA) Or Non-ST-Segment Elevation MI (NSTEMI) ]
Siedbar A
Ensure Emergency Intervention [B]
Initiate medication therapy [C]
Sidebar B
Admit To Monitored Bed, At Appropriate Level Of Care [D]
Assess , Serial ECGs, Cardiac-Specific Markers And Lipid Profile [E]
ACEI fro patioents with diabetes or LV disfunction
Treat Exacerbating Non-Cardiac Causes Of Unstable Angina [F]
Provide appropriate Antiplatelet and Anticoagulant Therapy [G]
Sidebar C
Are there Indications for Glycoprotein IIb/IIIa Receptor Blocker? [H]
Consider Platelet IIb/IIIa receptor blocker
Is There Indication For Urgent Angiography? [I] Refer to Cardiology Urgently
Assess Left Ventricular Function, If Indicated [J]
Is LV 0.40 (moderate or severe LV dysfunction)? Ensure Pharmacotherapy For CHF/LV Dysfunction [K] Sidebar D
Consider cardiac Stress Test [L]
Do test reaults indicate diagnosis of CAD with high/intermedite risk features, or indeterminate? Refer To Cardiology For Possible Angiography [M]
Do test results or other data indicate diagnosis of IHD?
Stop CAD therapy; Discharge; Re-evaluate fro cause of symptoms and address cardiovascular risk-factors Discharge and Follow-up [N]