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CORONARY
SYNDROME
Unstabl
e
Plaque
in ACS
Plaque
(lipid rich
core,
fibrious cap)
Plaque rupture
deposition of platelet
aggregates, thrombosis
Partial
occlusion
Partial
occlusion
thrombolysis
thrombosis
Monocytes,
macrophages,
inflammation
Complete
occlusion
Collaterals
Unstable angina
Non Q wave MI
Q wave MI
Non Q-wave MI
Rapid progression of
atherosclerosis
Angina,ECG changes,
Troponin release
Angina,ECG changes,
Troponin release
EKG:
ST Elevation (-)
ST Elevation (+)
Trop T (+)
UAP
NSTEMI/
Non-Q MI
STEMI/
Q MI
UAP: Unstable angina pectoris, Non-Q MI: Non-Q wave myocardial infarction
NSTEMI: Non ST-elevation myocardial infarction
STEMI: ST-elevation myocardial infarction, Q MI: Q wave myocardial infarction
Penatalaksanaa
n
SKA
*
EKG 12
sandapan
Petanda
biokimia
EKG Non diagnostikPerubahan ST/T
Elevasi
Petanda biokimia (-)
Petanda biokimia (+)
seg ST
Nyeri dada (-)
Nyeri dada menetap
EKG tdk
berubah
Petanda(-)
Nyeri dada(-)
Observasi
EKG serial
Ulang petanda
6-12 jam stlh
onset nyeri
Rawat Terapi
Nitrat
ASA
APTS/NSTE
Clopidogrel
UFH/LMWH
MI
(+/- Antagonis
Receptor
GPIIb/IIIa
Malaysian Clinical Practice Guideline
on UA/NSTEMI 2002
dada*
Perubahan
Risiko rendahRisiko tinggi seg ST
Periksa di
Periksa
Petanda (+)
Rawat jalan segera
Nyeri dada
menetap
Pulang
Evaluasi
utk
reperfusi