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Not Consistent With ACS ? Acs Very Consistent With ACS (Based On Clinical Features and ECG)

This document provides guidelines for evaluating and treating patients who may be experiencing acute coronary syndrome (ACS). It recommends clinicians first determine the pre-test probability of ACS based on symptoms and ECG. Serial troponin tests and ECGs should be done upon admission and at 3 and 6 hours. If troponin is below 14 ng/L, ACS is not consistent. Levels between 14-29 ng/L require further evaluation or trending. Over 30 ng/L or a rise of 10 ng/L indicates possible ACS and admission to cardiology. The guidelines note individual clinical discretion is also important.

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Vanessa Hermione
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50 views1 page

Not Consistent With ACS ? Acs Very Consistent With ACS (Based On Clinical Features and ECG)

This document provides guidelines for evaluating and treating patients who may be experiencing acute coronary syndrome (ACS). It recommends clinicians first determine the pre-test probability of ACS based on symptoms and ECG. Serial troponin tests and ECGs should be done upon admission and at 3 and 6 hours. If troponin is below 14 ng/L, ACS is not consistent. Levels between 14-29 ng/L require further evaluation or trending. Over 30 ng/L or a rise of 10 ng/L indicates possible ACS and admission to cardiology. The guidelines note individual clinical discretion is also important.

Uploaded by

Vanessa Hermione
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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Not Consistent with ACS ?

ACS Very Consistent with ACS

Consider DDx Clinician to formulate pre-test probability (based on clinical features and ECG)

Troponin generally not ordered Admit Cardiology

(at clinician’s discretion) Troponin does not r/o UA

Possible ACS

Consider SSU admission if meets criteria

Serial ECG and troponin stat and at 3 and 6


hours post onset of most significant
symptoms

HS Troponin T ≥ 30 ng/L
HS Troponin T 14 – 29 ng/L
HS Troponin T < 14 ng/L (99th percentile Or absolute change ≥ 10 ng/L
URL) If ongoing clinical uncertainty for
ACS, consider further trending Consider DDx
At 6 hours, not consistent with AMI
Consider DDx of other conditions Admit Cardiology if clinical picture
Serial measurement or further testing at e.g. PE, CCF consistent with ACS
clinician’s discretion
Consider outpatient Cardiology
NOTE: these are guidelines and do not override the
assessment (+/- Treadmill or CCTA)
individual responsibility of health professionals to
make appropriate decisions in the circumstances of
the individual patients

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