Thanks to Ann Robinson and cardiologist, Dr. Barbant, we learned some high-yield tid-bits about ACS! Here is the summary:
- History is everything! How do you distinguish the unstable vs stable angina?
- Is the CP relieved with rest? -> it’s stable.
- What other tests are needed to differentiate unstable angina/NSTEMI from STEMI?
- Troponin: if elevated will point to NSTEMI or STEMI
- EKG: if there are ST-segment depressions more likely NSTEMI, if ST-elevations are present then more likely STEMI
- How do we initially risk stratify patients with UA/NSTEMI?
- TIMI score: 14day risk of MI or ongoing ischemia
- HEART score (ED uses this one): Histroy, EKG, Age, Risk factors, Troponin. Risk of mortality of cardiac cause over 10years.
- In patients with low risk, how do we further risk stratify patients?
- Cardiac stress test! It is important to know what the indications and contraindications are for each of the stress tests.