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Managing patients with non-ST-segment elevation acute coronary syndrome Summary Acute coronary syndromes (ACSs) can be described as ST-segment elevation or non-ST-segment elevation, including unstable angina. Traditionally, ST-segment elevation ACS has been considered to be more serious, but non-ST-segment... 顯示更多 Managing patients with
non-ST-segment elevation
acute coronary syndrome

Summary
Acute coronary syndromes (ACSs) can be described as ST-segment
elevation or non-ST-segment elevation, including unstable angina.
Traditionally, ST-segment elevation ACS has been considered to be
more serious, but non-ST-segment elevation ACS has higher
mortality rates in the longer term. This article discusses diagnosis,
including history taking, clinical examination, electrocardiogram and
biochemical markers that help to differentiate between types of
non-ST-seginent elevation ACSs. Risk stratification and treatment
strategies are examined, as vi/ell as pharmacological treatments. The
nurse's role in assessment treatment, ongoing management and
discharge practice is discussed.

Introduction
ACSs are manifestations of ischaemic heart
disease which reflect the same underlying
pathophysiological mechanism, namely coronary
artery disease. They encompass acute clinical
presentations resulting from niyocardial
ischaemia (Bertrand efa/2002). When a
confirmed diagnosis of ACS is made, it is
classified according to ECG findings:
• ST-segment elevation ACS:
• ST-segment elevation myocardial infarction
(STEMI) which would indicate complete
occlusion of a coronary artery.
• Non-ST-segment elevation ACS:
• Non-ST-segment elevation myocardial
infarction (NSTEMI) and unstable angina
(UA). The ECG shows no ST-segment
elevation, but it may demonstrate signs of
ischaemia, such as ST-segment depression
and/or T-wave inversion. The degree of
coronary artery occlusion and resulting
myocardial ischaemia are less than in
STEMI.
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