UNSTABLE ANGINA - MANAGEMENT

see Angina

see Risk stratification of Angina

Features predicting risk of acute complications - MI/arrhythmias/cardiogenic shock

  • Unrelieved chest pain
  • Gallop rhythm
  • Hypotension
  • ST depression
  • Arrhythmias
  • Cardiac enzyme rise

If present go to  Unstable Angina - High risk

Treatment

Treatment needs to be escalated from usual stable angina management because of the risk of progression to MI

  • Aspirin 300 mg daily PO
  • Heparin bolus + infusion (may omit if chest pain indeterminate)

Repeat ECG at 12 hours of if pain recurs

If ECG shows ST segment elevation - see Acute myocardial infarction)

If patient develops high risk features - see  Unstable Angina - High risk

Disposal

Admit to non-monitored bed