5. Based on the ECG, two groups of patients should be
(1)Patients with acute chest pain and persistent (>20 min) ST-
segment elevation (ST-elevation ACS )
(2) Patients with acute chest pain but no persistent ST-
segment elevation (Non-ST-elevation ACS)
ECG changes may include transient ST-segment elevation,
persistent or transient ST-segment depression, T-wave
inversion, flat T waves or pseudo-normalization of T waves
or the ECG may be normal.
The leading symptom that initiates the diagnostic and
therapeutic cascade in patients with suspected acute
coronary syndromes is chest pain.
6. Initial assessment of patients with suspected acute coronary syndromes
“Other cardiac” includes, among other, myocarditis, Tako-Tsubo cardiomyopathy, or
tachyarrhythmias. “Non-cardiac” refers to thoracic diseases such as pneumonia or
pneumothorax. . If the initial evaluation suggests aortic dissection or pulmonary embolism,
D-dimers and MDCT angiography are recommended
24. Ischemic RiskBleeding Risk
Balanced Benefit/Risk Ratio
Tailoring antiplatelet therapy :
a step toward individualized therapy to improve clinical outcome?
Thus, the thousand dollar question is :
Where is the sweet spot between
ischaemia and bleeding?
25. A call for individualised medicine
One Size Does Not Fit All
( Personalized medicine )
26. Factors for physicians to consider in determining the optimal
duration of DAPT after DES implantation for individual patients
Eisen, A. & Bhatt, D. L. (2015) Defining the optimal duration of DAPT
after PCI with DES Nat. Rev. Cardiol. doi:10.1038/nrcardio.2015.87