What is the initial treatment for ACS?

Morphine (or fentanyl) for pain control, oxygen, sublingual or intravenous (IV) nitroglycerin, soluble aspirin 162-325 mg, and clopidogrel with a 300- to 600-mg loading dose are given as initial treatment.

Which segment of ACS treatment can have the longest delay?

The pre-hospital delays include patient, doctor and emergency medical transport (EMT) delay. Patient delay is among the longest in the pre-hospital chain of ACS patients.

What is a NSTE ACS?

Introduction. Non ST-elevation acute coronary syndrome (NSTE-ACS, here defined as unstable angina and non ST-elevation MI) is characterised by episodes of chest pain at rest or with minimal exertion, which increase in frequency or severity, often with dynamic ECG changes.

Why is aspirin given for ACS?

Aspirin in Acute Coronary Syndrome 1: Aspirin acts to inhibit the activity of the cyclooxygenase enzyme and thus attenuates the production of prostaglandins and thromboxane. 2: The ADP receptor antagonists bind to the P2Y12 receptor to prevent ADP-induced platelet activation.

What is the most common cause of ACS?

Acute coronary syndrome (ACS) is caused primarily by atherosclerosis. Most cases of ACS occur from disruption of a previously nonsevere lesion (an atherosclerotic lesion that was previously hemodynamically insignificant yet vulnerable to rupture).

What is a distinguishing ECG finding of ACS?

In acute coronary syndrome, common electrocardiographic abnormalities include T-wave tenting or inversion, ST-segment elevation or depression (including J-point elevation in multiple leads), and pathologic Q waves.

When is nitroglycerin contraindicated in ACS?

Nitroglycerin is contraindicated in patients that have reported allergic symptoms to the medication. [18] Known history of increased intracranial pressure, severe anemia, right-sided myocardial infarction, or hypersensitivity to nitroglycerin are contraindications to nitroglycerin therapy.

Is NSTE-ACS the same as NSTEMI?

For the sake of clarity: NSTE-ACS is defined as an acute coronary syndrome without ST elevations on ECG. The majority of patients with NSTE-ACS will exhibit elevated troponins, which is evidence for myocardial infarction and therefore defines the condition as NSTEMI (Non ST Elevation Myocardial Infarction).

Does unstable angina show on ECG?

The ECG in unstable angina may show hyperacute T-wave, flattening of the T-waves, inverted T-waves, and ST depression. ST elevations indicate STEMI and these patients should be treated with percutaneous coronary intervention or thrombolytics while they wait on the availability of a catheterization lab.

Why is clopidogrel given for MI?

Clopidogrel reduces the risk of death and cardiovascular complications in patients with symptomatic atherosclerotic disease, in the setting of percutaneous coronary intervention (PCI), and in patients with unstable angina or non-STEMI.

What are the 3 types of ACS?

Non-ST-elevation myocardial infarction (NSTEMI), ST-elevation MI (STEMI), and unstable angina are the three traditional types of ACS.

How long does chest pain in ACS last for?

It may be similar to a bout of normal (stable) angina. However, it is usually more severe and lasts longer. ACS pain usually lasts more than 15 minutes.

What are 3 changes found on an EKG in a patient with an acute coronary syndrome?

Diagnosis requires an electrocardiogram and a careful review for signs and symptoms of cardiac ischemia. In acute coronary syndrome, common electrocardiographic abnormalities include T-wave tenting or inversion, ST-segment elevation or depression (including J-point elevation in multiple leads), and pathologic Q waves.

When should you not give Nitro for chest pain?

Why do you not give Nitro to right sided MI?

Nitroglycerin is also contraindicated in the setting of an inferior MI with right ventricular involvement because, in this specific situation, the heart is dependent on preload.

Can you see an NSTEMI on an ECG?

Non-ST-elevation myocardial infarction (NSTEMI) is an acute ischemic event causing myocyte necrosis. The initial ECG may show ischemic changes such as ST depressions, T-wave inversions, or transient ST elevations; however, it may also be normal or show nonspecific changes.

What is the mechanism of action of Ranexa?

Ranexa is an anti-ischemic and anti-anginal drug. It works by inhibiting what is known as the “late sodium current” to reduce sodium overload in the heart. The inhibition of this sodium channel causes a reduction of sodium in the heart cells and, therefore, decreases calcium.

Is there an extended-release version of Ranexa?

Ranexa (ranolazine) is available as an extended-release tablet for oral administration. Ranolazine is a racemic mixture and chemically described as 1-piperazineacetamide, N-(2,6-dimethylphenyl)-4- [2-hydroxy-3-(2-methoxyphenoxy)propyl]-,(±)-.

What is Ranexa used for in the treatment of angina?

Last updated on Nov 1, 2019. Ranexa ® is indicated for the treatment of chronic angina. Ranexa may be used with beta-blockers, nitrates, calcium channel blockers, anti-platelet therapy, lipid-lowering therapy, ACE inhibitors, and angiotensin receptor blockers.

How much Ranexa can I take for chest pain?

Usual Adult Dose of Ranexa for Angina (Chest Pain): The typical starting dose is: 500 mg orally twice daily. If needed, your doctor may increase to 1000 mg orally twice daily.