ACUTE CORONARY SYNDROME

Nguyen Van Si
Department of Internal Medicine

CARDIOVASCULAR RISK FACTORS

CORONARY HEART DISEASE

STABLE ANGINA
Retrosternal chest discomfort
Pressure, heaviness, squeezing, burning, or choking
sensation
Radiation of pain are arms, shoulders, and neck
Precipitated by exertion, exposure to cold, or emotional stress
Relieved by rest or nitroglycerin

ANGINA PECTORIS

UNSTABLE ANGINA
At least one of the following
Occurs at rest or minimal exertion and usually lasts >20 minutes
Being severe and described as frank pain, and of new onset
(within 1 month)
Crescendo pattern (more severe, prolonged, or increased
frequency than previously)

ACUTE CORONARY SYNDROME

ECG
CARDIAC
MARKERS

ACUTE CORONARY SYNDROME

ST elevation myocardial infarction
Non-ST elevation myocardial infarction
Unstable angina

ELECTROCARDIOGRAPHY

ELECTROCARDIOGRAPHY

CARDIAC BIOMARKERS

Treatment
ST ELEVATION MYOCARDIAL INFARCTION

TREATMENT
Routine Measures

ANTIPLATELET

Oxygen
Nitrate
Morphine sulfate

Aspirin
Clopidogrel

TREATMENT
Anticoagulant

STATIN

Unfractionated heparin
Low molecular weight
heparin

For plaque stabilization

Regardless of lipid level

TREATMENT
Beta Blocker

INHIBITION OF RAAS

Beta-blocker should be
administered promptly

ACE inhibitor should be

administered within 24 hrs.
ARB if ACE inhibitor is
intolerant

TREATMENT

TREATMENT

THANK YOU FOR YOUR ATTENTION