2. WHAT IS ACS?
• Acute coronary syndrome refers to spectrum of conditions that causes
acute myocardial ischemia as blood supply to the heart muscles is
suddenly blocked.
• It includes:
• 1. unstable angina
• 2. Myocardial infarction - STEMI, STEMI
14. MANAGEMENT OF ACS
• Maintain IV line
• Oxygen therapy
• Pain relief: IV Morphine (5-10mg)
• Aspirin 300mg (then 75mg daily)
• Clopidogrel (Lowplat 300mg)
• Nitroglyerin 1 tab S/L
• IV Heparin -1cc (5000 units)
• B-blocker
• Abciximab (Glycoprotein IIIb/IIa
inhibitor) - NSTEMI/ UA
• REPERFUSION THERAPY - Only in
STEMI
15. PRIMARY CORONARY INTERVENTION
• Most effective if done within first
90 mins of cardiac event
• Restores patency of the vessel by
implanting stent in the diseased
area.
• After implantation of a stent,
Aspirin combined with Clopidogrel
for 3 to 6 months given to prevent
thrombosis and restenosis.
16. REPERFUSION THERAPY
• Thrombolysis: Within first 20 mins of presentation to hospital.
• Streptokinase
• Tissue Plasminogen activator (tPa) eg. Altepase, Reteplase
