Unstable angina non ST elevation myocardial infarction: Difference between revisions

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Unstable Angina
Non-ST Elevation Myocardial Infarction
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Antiplatelet therapy recommendations
Aspirin
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Glycoprotein IIb/IIIa Inhibitor
Anticoagulant Therapy
Additional Management Considerations for Antiplatelet and Anticoagulant Therapy
Risk Stratification Before Discharge for Patients With an Ischemia-Guided Strategy of NSTE-ACS
Mechanical Reperfusion
Initial Conservative Versus Initial Invasive Strategies
PCI
CABG
Complications of Bleeding and Transfusion
Discharge Care
Medical Regimen
Post-Discharge Follow-Up
Cardiac Rehabilitation
Long-Term Medical Therapy and Secondary Prevention
ICD implantation within 40 days of myocardial infarction
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Case #1
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Latest revision as of 20:57, 5 December 2022

For patient information, click here

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]; Varun Kumar, M.B.B.S.; Lakshmi Gopalakrishnan, M.B.B.S.; Smita Kohli, M.D.; Neil Gheewala, M.D. [3]; Bryan Piccirillo, B.S., M.D.

Synonyms and keywords: Angina at rest; rest angina; progressive angina; crescendo angina; accelerating angina; new-onset angina; pre-infarction angina; unstable angina pectoris; UAP; UA; new-onset angina; angina - unstable

Overview

Classification

Pathophysiology

Unstable Angina | Non-ST Elevation Myocardial Infarction

Differentiating Unstable Angina/Non-ST Elevation Myocardial Infarction from other Disorders

Epidemiology and Demographics

Risk Stratification

Natural History, Complications and Prognosis

Special Groups

Diagnosis

Treatment

Primary Prevention

Antiplatelet Agents: Antiplatelet Therapy Recommendations | Aspirin | Thienopyridines | Glycoprotein IIb/IIIa Inhibitor | Additional Management Considerations

Mechanical Reperfusion: Initial Conservative Versus Initial Invasive Strategies | PCI | CABG

Discharge Care: Medical Regimen | Post-Discharge Follow-Up | Cardiac Rehabilitation

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Contraindicated medications

Unstable angina is considered an absolute contraindication to the use of the following medications:

Case Studies

Case #1

Related Chapters

External Links

Clinical Trial Results: An up to date resource of Cardiovascular Research
Risk Assessment Tool for Estimating Your 10-year Risk of Having a Heart Attack - based on information of the Framingham Heart Study, from the United States National Heart, Lung and Blood Institute

Template:WikiDoc Sources

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-'''For patient information click [[Unstable angina / non ST elevation myocardial infarction (patient information)|here]]'''
+__NOTOC__
+{| class="infobox" style="float:right;"
+|-
+| [[File:Siren.gif|30px|link=Unstable angina/ NSTEMI resident survival guide]]|| <br> || <br>
+| [[Unstable angina/ NSTEMI resident survival guide|'''Resident'''<br>'''Survival'''<br>'''Guide''']]
+|}
+{{Unstable angina / NSTEMI}}
-'''{{Infobox_Disease
+'''For patient information, click [[Unstable angina / non ST elevation myocardial infarction (patient information)|here]]'''
-| Name           = Unstable angina pectoris
-| Image          =
+{{CMG}}; '''Associate Editor(s)-In-Chief:''' {{CZ}}; [[Varun Kumar]], M.B.B.S.; [[Lakshmi Gopalakrishnan]], M.B.B.S.; Smita Kohli, M.D.; {{NMG}}; Bryan Piccirillo, B.S., M.D.
-| Caption        =
-| DiseasesDB     = 8695
-| ICD10          = {{ICD10|I|20||i|20}}
-| ICD9           = {{ICD9|413}}
-| ICDO           =
-| OMIM           =
-| MedlinePlus    =
-| eMedicineSubj  =
-| eMedicineTopic =
-| MeshID         = D000787
-}}
-{{Unstable angina / NSTEMI}}
-{{CMG}}; '''Associate Editor(s)-In-Chief:''' {{CZ}}; [[Varun Kumar]], M.B.B.S.; [[Lakshmi Gopalakrishnan]], M.B.B.S.; Smita Kohli, M.D.; {{NMG}}
-'''''Synonyms and related keywords''''': angina at rest, rest angina, progressive angina, crescendo angina, accelerating angina, new-onset angina, pre-infarction angina, unstable angina pectoris, UAP, UA
+{{SK}} Angina at rest; rest angina; progressive angina; crescendo angina; accelerating angina; new-onset angina; pre-infarction angina; unstable angina pectoris; UAP; UA; new-onset angina; angina - unstable
 ==[[Unstable angina / non ST elevation myocardial infarction overview | Overview]]==
-[[Acute coronary syndrome]]s ([[ACS]]) is a term that encompasses [[unstable angina]] ([[UA]]), [[non-ST-segment elevation myocardial infarction]] ([[NSTEMI]]) and [[ST-segment elevation myocardial infarction]] ([[STEMI]]).
-While all three usually result from [[atherosclerotic plaque rupture]] and subsequent [[thrombus|thrombus formation]] in one of the main epicardial coronary arteries, with subsequent inadequate blood supply to meet the oxygen and metabolic demands of the [[myocardium]]. Other possible etiologies of this imbalance such as coronary artery narrowing alone, [[coronary spasm]], or [[coronary dissection]].
+==[[Unstable angina / non ST elevation myocardial infarction classification | Classification]]==
-Unstable angina, [[NSTEMI]] and [[STEMI]] are distinguished pathophysiologically as to whether or not the [[thrombus]] is '''occlusive''' (as in the case of [[STEMI]]) or '''non-occlusive'''(as in the case of [[UA]] and [[NSTEMI]]). If an electrocardiogram ([[EKG]]) is performed at the time that an [[occlusive coronary artery thrombus]] is formed, it will usually show [[ST-segment elevation]] in the leads which correspond to the territory of [[myocardium]] in which blood supply has been disrupted (see [[ST Elevation Myocardial Infarction Electrocardiogram|Electrocardiogram]]). If an EKG is performed at the time that a [[non-occlusive thrombus]] is formed, it may or may not show signs of [[ischemia]](see [[Unstable angina / NSTEMI ECG|Electrocardiogram]]).
+==[[Unstable angina / non ST elevation myocardial infarction pathophysiology| Pathophysiology]]==
+[[Unstable angina pathophysiology|Unstable Angina]] | [[Non ST elevation myocardial infarction pathophysiology|Non-ST Elevation Myocardial Infarction]]
-Frequently, [[Unstable Angina]] and [[NSTEMI]] are indistinguishable on inital evaluation as these two conditions are at different spectrums of [[ischemia]].  If the ischemia is significant to cause myocardial damage, there will be an elevation of Cardiac biomarkers ([[CK-MB]] or [[troponin]]) and would be classified as an [[NSTEMI]](see [[Unstable angina / NSTEMI bio markers|Biomarkers]]).  Often, these may not be detected for up to 12 hours in the bloodstream, which emphasizes the need for thorough evaluation. <ref name="Anderson"> Anderson JL, Adams CD, Antman EM, Bridges CR, Califf RM, Casey DE Jr, Chavey WE II, Fesmire FM, Hochman JS, Levin TN, Lincoff AM, Peterson ED, Theroux P, Wenger NK, Wright RS. ACC/AHA 2007 guidelines for the management of patients with unstable angina/non–ST-elevation myocardial infarction: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 2002 Guidelines for the Management of Patients With Unstable Angina/Non–ST-Elevation Myocardial Infarction).'' Circulation 2007 116: e148 – e304. PMID 17679616</ref> <ref name="Anderson2"> Anderson JL, Adams CD, Antman EM, Bridges CR, Califf RM, Casey DE Jr, Chavey WE II, Fesmire FM, Hochman JS, Levin TN, Lincoff AM, Peterson ED, Theroux P, Wenger NK, Wright RS. Correction of ACC/AHA 2007 guidelines for the management of patients with unstable angina/non–ST-elevation myocardial infarction: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 2002 Guidelines for the Management of Patients With Unstable Angina/Non–ST-Elevation Myocardial Infarction).'' J Am Coll Cardiol. 2008 Mar 4; 51(9): 974. PMID 17692738 </ref>
+==[[Chest pain differential diagnosis|Differentiating Unstable Angina/Non-ST Elevation Myocardial Infarction from other Disorders]]==
-==Pathophysiology and Etiology==
+==[[Unstable angina / non ST elevation myocardial infarction epidemiology and demographics | Epidemiology and Demographics]]==
-[[Unstable angina pathophysiology & etiology|Unstable Angina]] | [[Non ST elevation myocardial infarction pathophysiology & etiology|Non-ST Elevation Myocardial Infarction]]
-==[[Unstable angina / non ST elevation myocardial infarction epidemiology and demographics | Epidemiology and Demographics]]==
+==[[Unstable angina / non ST elevation myocardial infarction risk stratification and prognosis|Risk Stratification]]==
-==Risk Factors==
+==[[Unstable angina / non ST elevation myocardial infarction natural history, complications and prognosis|Natural History, Complications and Prognosis]]==
-[[Unstable angina / non ST elevation myocardial infarction risk stratification and prognosis|Risk Stratification]] | [[Unstable angina / non ST elevation myocardial infarction ACC/AHA guidelines for early risk stratification |Guidelines for Early Risk Stratification]] | [[Unstable angina / non ST elevation myocardial infarction ACC/AHA guidelines for risk stratification before discharge |Guidelines for Risk Stratification before discharge]]
-==[[Unstable angina / non ST elevation myocardial infarction natural history, complications and prognosis|Natural history, Complications and Prognosis]]==
+==Special Groups==
+[[Unstable angina / non ST elevation myocardial infarction women | Women]]  |  [[Unstable angina / non ST elevation myocardial infarction diabetic patients | Diabetic Patients]]  |  [[Unstable angina / non ST elevation myocardial infarction post CABG patients | Post CABG Patients]]  |  [[Unstable angina / non ST elevation myocardial infarction elderly | Elderly]]  |  [[Unstable angina / non ST elevation myocardial infarction chronic kidney disease | Chronic Kidney Disease]]  |  [[Unstable angina / non ST elevation myocardial infarction drug and substance abusers | Substance Abusers]]  |  [[Unstable angina / non ST elevation myocardial infarction prinzmetal's angina | Prinzmetal's Angina]]  |  [[Unstable angina / non ST elevation myocardial infarction cardiovascular syndrome x | Cardiovascular Syndrome X]]
 ==Diagnosis==
-[[Chest pain|Differential diagnosis]] |  [[Unstable angina / non ST elevation myocardial infarction initial therapy | Initial Therapy]] | [[Unstable angina / non ST elevation myocardial infarction symptoms|History & Symptoms]] | [[Unstable angina / non ST elevation myocardial infarction physical examination|Physical Examination]] | [[Unstable angina / non ST elevation myocardial infarction biomarkers |Biomarkers]] | [[Unstable angina / non ST elevation myocardial infarction electrocardiogram|Electrocardiogram]] | [[Unstable angina / non ST elevation myocardial infarction chest x-ray|Chest X-Ray]] | [[Unstable angina / non ST elevation myocardial infarction echocardiogram | Echocardiography]] | [[Unstable angina / non ST elevation myocardial infarction coronary angiography| Coronary Angiography]]
+[[Unstable angina / non ST elevation myocardial infarction symptoms|History and Symptoms]] | [[Unstable angina / non ST elevation myocardial infarction physical examination|Physical Examination]] | [[Unstable angina / non ST elevation myocardial infarction blood studies|Blood Studies]] | [[Unstable angina / non ST elevation myocardial infarction biomarkers |Biomarkers]] | [[Unstable angina / non ST elevation myocardial infarction electrocardiogram|Electrocardiogram]] | [[Unstable angina / non ST elevation myocardial infarction chest x-ray|Chest X Ray]] | [[Unstable angina / non ST elevation myocardial infarction echocardiogram |Echocardiography]] | [[Unstable angina / non ST elevation myocardial infarction coronary angiography| Coronary Angiography]]
-==[[Unstable angina treatment| Treatment]]==
+==[[Unstable angina treatment|Treatment]]==
-'''Pre-hospital Care :'''  [[Unstable angina / non ST elevation myocardial infarction prehospital care before onset| Before Onset]] | [[Unstable angina / non ST elevation myocardial infarction prehospital care after onset| After Onset]]
-'''Immediate Management :'''
+'''[[Unstable angina / non ST elevation myocardial infarction primary prevention|Primary Prevention]]'''
-[[Unstable angina / non ST elevation myocardial infarction immediate management | Overview]] | [[Unstable angina / non ST elevation myocardial infarction oxygen therapy |Oxygen]] | [[Unstable angina / non ST elevation myocardial infarction nitrate therapy |Nitrates]] | [[Unstable angina / non ST elevation myocardial infarction analgesics | Analgesics]] | [[Unstable angina / non ST elevation myocardial infarction beta blockers | Beta Blockers]] | [[Unstable angina / non ST elevation myocardial infarction calcium channel blockers| Calcium Channel Blocker]] | [[Unstable angina / non ST elevation myocardial infarction inhibitors of RAS | Inhibitors of Renin-Angiotensin-Aldosterone axis]] | [[Unstable angina / non ST elevation myocardial infarction ACC/AHA guidelines for immediate management| ACC/AHA Guidelines for immediate management]]
-'''Antithrombin Therapy :''' [[Unstable angina / non ST elevation myocardial infarction anticoagulant therapy | Overview]] | [[Unstable angina / non ST elevation myocardial infarction unfractionated heparin therapy |Unfractionated Heparin]] | [[Unstable angina / non ST elevation myocardial infarction low molecular weight heparin therapy |Low Molecular Weight Heparin]] | [[Unstable angina / non ST elevation myocardial infarction direct thrombin inhibitors therapy |Direct Thrombin Inhibitors]] | [[Unstable angina / non ST elevation myocardial infarction factor Xa inhibitors therapy |Factor Xa Inhibitors]] | [[Unstable angina / non ST elevation myocardial infarction long term anticoagulation therapy |Long Term Anticoagulation]] | [[Unstable angina / non ST elevation myocardial infarction ACC/AHA guidelines for anticoagulation therapy|ACC/AHA Guidelines for Anticoagulation]]
+'''Immediate Management:''' [[Unstable angina / non ST elevation myocardial infarction immediate management | Overview]] | [[Unstable angina / non ST elevation myocardial infarction oxygen therapy |Oxygen]] | [[Unstable angina / non ST elevation myocardial infarction nitrate therapy |Nitrates]] | [[Unstable angina / non ST elevation myocardial infarction analgesics | Analgesics]] | [[Unstable angina / non ST elevation myocardial infarction beta blockers | Beta Blockers]] | [[Unstable angina / non ST elevation myocardial infarction calcium channel blockers| Calcium Channel Blocker]] | [[Unstable angina / non ST elevation myocardial infarction inhibitors of RAS | Renin-Angiotensin-Aldosterone Inhibitors]]
-'''Antitplatelet Agents :''' [[Unstable angina / non ST elevation myocardial infarction aspirin therapy|Aspirin]] | [[Unstable angina / non ST elevation myocardial infarction thienopyridines|Thienopyridines]] | [[Unstable angina / non ST elevation myocardial infarction GPIIb/IIIa inhibitor|Glycoprotein IIb/IIIa Inhibitor]]
+'''Antithrombin Therapy:''' [[Unstable angina / non ST elevation myocardial infarction anticoagulant therapy | Overview]] | [[Unstable angina / non ST elevation myocardial infarction unfractionated heparin therapy |Unfractionated Heparin]] | [[Unstable angina / non ST elevation myocardial infarction low molecular weight heparin therapy |Low Molecular Weight Heparin]] | [[Unstable angina / non ST elevation myocardial infarction direct thrombin inhibitors therapy |Direct Thrombin Inhibitors]] | [[Unstable angina / non ST elevation myocardial infarction factor Xa inhibitors therapy |Factor Xa Inhibitors]] | [[Unstable angina / non ST elevation myocardial infarction long term anticoagulation therapy |Long Term Anticoagulation]]
-[[Unstable angina / non ST elevation myocardial infarction additional management considerations for antiplatelet and anticoagulant therapy | Additional Management Considerations for Antiplatelet and Anticoagulant Therapy]]
+'''Antiplatelet Agents:''' [[Unstable angina/NSTEMI Antiplatelet therapy recommendations|Antiplatelet Therapy Recommendations]] | [[Unstable angina / non ST elevation myocardial infarction aspirin therapy|Aspirin]] | [[Unstable angina / non ST elevation myocardial infarction thienopyridines|Thienopyridines]] | [[Unstable angina / non ST elevation myocardial infarction GPIIb/IIIa inhibitor|Glycoprotein IIb/IIIa Inhibitor]] |[[Unstable angina / non ST elevation myocardial infarction additional management considerations for antiplatelet and anticoagulant therapy | Additional Management Considerations]]
-'''Mechanical Reperfusion :''' [[Unstable angina / non ST elevation myocardial infarction initial conservative versus initial invasive strategies | Initial Conservative Versus Initial Invasive Strategies]] | [[Unstable angina / non ST elevation myocardial infarction recommendations for PCI‎ | PCI]] | [[Unstable angina / non ST elevation myocardial infarction recommendations for CABG | CABG]]
+'''Mechanical Reperfusion:''' [[Unstable angina / non ST elevation myocardial infarction initial conservative versus initial invasive strategies | Initial Conservative Versus Initial Invasive Strategies]] | [[Unstable angina / non ST elevation myocardial infarction recommendations for PCI‎ | PCI]] | [[Unstable angina / non ST elevation myocardial infarction recommendations for CABG | CABG]]
-==Complications of Bleeding and Transfusion==
+'''Complications of Bleeding and Transfusion:''' [[Unstable angina / non ST elevation myocardial infarction complications of bleeding and transfusion|Overview]] | [[Unstable angina / non ST elevation myocardial infarction complications of bleeding and transfusion incidence |Incidence]] | [[Unstable angina / non ST elevation myocardial infarction complications of bleeding and transfusion - definitions for bleeding complications |Definitions]] | [[Unstable angina / non ST elevation myocardial infarction complications of bleeding and transfusion - predictors and causes of bleeding |Predictors and Causes of Bleeding]] | [[Unstable angina / non ST elevation myocardial infarction complications of bleeding and transfusion - blood transfusions |Blood Transfusions]] | [[Unstable angina / non ST elevation myocardial infarction complications of bleeding and transfusion prognosis |Prognosis]] | [[Unstable angina / non ST elevation myocardial infarction complications of bleeding and transfusion prevention |Prevention]] | [[Unstable angina / non ST elevation myocardial infarction complications of bleeding and transfusion recommendations |Recommendations]]
-[[Unstable angina / non ST elevation myocardial infarction complications of bleeding and transfusion|Overview]] | [[Unstable angina / non ST elevation myocardial infarction complications of bleeding and transfusion incidence |Incidence]] | [[Unstable angina / non ST elevation myocardial infarction complications of bleeding and transfusion - definitions for bleeding complications |Definitions]] | [[Unstable angina / non ST elevation myocardial infarction complications of bleeding and transfusion - predictors and causes of bleeding |Predictors and Causes of Bleeding]] | [[Unstable angina / non ST elevation myocardial infarction complications of bleeding and transfusion - blood transfusions |Blood Transfusions]] | [[Unstable angina / non ST elevation myocardial infarction complications of bleeding and transfusion prognosis |Prognosis]] | [[Unstable angina / non ST elevation myocardial infarction complications of bleeding and transfusion prevention |Prevention]] | [[Unstable angina / non ST elevation myocardial infarction complications of bleeding and transfusion recommendations |Recommendations]]
-==Discharge Care==
+'''Discharge Care:''' [[Unstable angina / non ST elevation myocardial infarction medical regimen and use of medications | Medical Regimen]] | [[Unstable angina / non ST elevation myocardial infarction post-discharge follow-up | Post-Discharge Follow-Up]] | [[Unstable angina / non ST elevation myocardial infarction cardiac rehabilitation | Cardiac Rehabilitation]]
-[[Unstable angina / non ST elevation myocardial infarction medical regimen and use of medications | Medical Regimen]] | [[Unstable angina / non ST elevation myocardial infarction post-discharge follow-up | Post-Discharge Follow-Up]] | [[Unstable angina / non ST elevation myocardial infarction cardiac rehabilitation | Cardiac Rehabilitation]]
-==Long-Term Medical Therapy and Secondary Prevention==
+'''Long-Term Medical Therapy and Secondary Prevention:''' [[Unstable angina / non ST elevation myocardial infarction long-term medical therapy and secondary prevention |Overview]] | [[Unstable angina / non ST elevation myocardial infarction long-term medical therapy and secondary prevention ACC/AHA guidelines for antiplatelet therapy|Convalescent and Long-Term Antiplatelet Therapy]] | [[Unstable angina / non ST elevation myocardial infarction long-term medical therapy and secondary prevention ACC/AHA guidelines for beta blockers|Beta Blockers]] | [[Unstable angina / non ST elevation myocardial infarction long-term medical therapy and secondary prevention ACC/AHA guidelines for inhibitors of the RAS|Inhibition Of The Renin-Angiotensin-Aldosterone System]] | [[Unstable angina / non ST elevation myocardial infarction long-term medical therapy and secondary prevention ACC/AHA guidelines for nitroglycerin|Nitroglycerin Therapy]] | [[Unstable angina / non ST elevation myocardial infarction long-term medical therapy and secondary prevention ACC/AHA guidelines for calcium channel blockers|Calcium Channel Blockers]] | [[Unstable angina / non ST elevation myocardial infarction long-term medical therapy and secondary prevention ACC/AHA guidelines for warfarin therapy|Warfarin Therapy]] | [[Unstable angina / non ST elevation myocardial infarction long-term medical therapy and secondary prevention ACC/AHA guidelines for lipid management|Lipid Management]] | [[Unstable angina / non ST elevation myocardial infarction long-term medical therapy and secondary prevention ACC/AHA guidelines for blood pressure control|Blood Pressure Control]] | [[Unstable angina / non ST elevation myocardial infarction long-term medical therapy and secondary prevention ACC/AHA guidelines for smoking cessation|Smoking Cessation]] | [[Unstable angina / non ST elevation myocardial infarction long-term medical therapy and secondary prevention ACC/AHA guidelines for weight management|Weight Management]] | [[UA/NSTEMI long-term medical therapy and secondary prevention ACC/AHA guidelines for Physical Activity|Physical Activity]] | [[Unstable angina / non ST elevation myocardial infarction long-term medical therapy and secondary prevention ACC/AHA guidelines for patient education|Patient Education]] | [[Unstable angina / non ST elevation myocardial infarction long-term medical therapy and secondary prevention ACC/AHA guidelines for influenza|Influenza]] | [[UA/NSTEMI long-term medical therapy and secondary prevention ACC/AHA guidelines depression|Depression]] | [[Unstable angina / non ST elevation myocardial infarction long-term medical therapy and secondary prevention ACC/AHA guidelines nonsteroidal anti-inflammatory drugs|Nonsteroidal Anti-Inflammatory Drugs]] | [[Unstable angina / non ST elevation myocardial infarction long-term medical therapy and secondary prevention ACC/AHA guidelines hormone therapy|Hormone Therapy]] | [[Unstable angina / non ST elevation myocardial infarction long-term medical therapy and secondary prevention ACC/AHA guidelines antioxidant vitamins and folic acid|Antioxidant Vitamins and Folic Acid]] | [[Unstable angina / non ST elevation myocardial infarction long-term medical therapy and secondary prevention ACC/AHA guidelines quality care and outcomes|Quality Care and Outcomes]]
-[[Unstable angina / non ST elevation myocardial infarction long-term medical therapy and secondary prevention |Overview]] | [[Unstable angina / non ST elevation myocardial infarction long-term medical therapy and secondary prevention ACC/AHA guidelines for antiplatelet therapy|Antiplatelet Therapy]] | [[Unstable angina / non ST elevation myocardial infarction long-term medical therapy and secondary prevention ACC/AHA guidelines for beta blockers|Beta Blockers]] | [[Unstable angina / non ST elevation myocardial infarction long-term medical therapy and secondary prevention ACC/AHA guidelines for inhibitors of the RAS|Inhibition Of The Renin-Angiotensin-Aldosterone System]] | [[Unstable angina / non ST elevation myocardial infarction long-term medical therapy and secondary prevention ACC/AHA guidelines for nitroglycerin|Nitroglycerin Therapy]] | [[Unstable angina / non ST elevation myocardial infarction long-term medical therapy and secondary prevention ACC/AHA guidelines for calcium channel blockers|Calcium Channel Blockers]] | [[Unstable angina / non ST elevation myocardial infarction long-term medical therapy and secondary prevention ACC/AHA guidelines for warfarin therapy|Warfarin Therapy]] | [[Unstable angina / non ST elevation myocardial infarction long-term medical therapy and secondary prevention ACC/AHA guidelines for lipid management|Lipid Management]] | [[Unstable angina / non ST elevation myocardial infarction long-term medical therapy and secondary prevention ACC/AHA guidelines for blood pressure control|Blood Pressure Control]] | [[Unstable angina / non ST elevation myocardial infarction long-term medical therapy and secondary prevention ACC/AHA guidelines for diabetes mellitus|Diabetes Mellitus]] | [[Unstable angina / non ST elevation myocardial infarction long-term medical therapy and secondary prevention ACC/AHA guidelines for smoking cessation|Smoking Cessation]] | [[Unstable angina / non ST elevation myocardial infarction long-term medical therapy and secondary prevention ACC/AHA guidelines for weight management|Weight Management]] | [[Unstable angina / non ST elevation myocardial infarction long-term medical therapy and secondary prevention ACC/AHA guidelines for physical activity|Physical Activity]] | [[Unstable angina / non ST elevation myocardial infarction long-term medical therapy and secondary prevention ACC/AHA guidelines patient education|Patient Education]] | [[Unstable angina / non ST elevation myocardial infarction long-term medical therapy and secondary prevention ACC/AHA guidelines influenza vaccination|Influenza Vaccination]] | [[Unstable angina / non ST elevation myocardial infarction long-term medical therapy and secondary prevention ACC/AHA guidelines depression|Depression]] | [[Unstable angina / non ST elevation myocardial infarction long-term medical therapy and secondary prevention ACC/AHA guidelines nonsteroidal anti-inflammatory drugs|Nonsteroidal Anti-Inflammatory Drugs]] | [[Unstable angina / non ST elevation myocardial infarction long-term medical therapy and secondary prevention ACC/AHA guidelines hormone therapy|Hormone Therapy]] | [[Unstable angina / non ST elevation myocardial infarction long-term medical therapy and secondary prevention ACC/AHA guidelines antioxidant vitamins and folic acid|Antioxidant Vitamins and Folic Acid]]
-==Special Groups==
+'''[[Unstable angina / non ST elevation myocardial infarction cost-effectiveness of therapy|Cost-Effectiveness of Therapy]]'''
-[[Unstable angina / non ST elevation myocardial infarction women | Women]]  |  [[Unstable angina / non ST elevation myocardial infarction diabetic patients | Diabetic Patients]]  |  [[Unstable angina / non ST elevation myocardial infarction post CABG patients | Post CABG Patients]]  |  [[Unstable angina / non ST elevation myocardial infarction elderly | Elderly]]  |  [[Unstable angina / non ST elevation myocardial infarction chronic kidney disease | Chronic Kidney Disease]]  |  [[Unstable angina / non ST elevation myocardial infarction drug and substance abusers | Drug and Substance Abusers]]  |  [[Unstable angina / non ST elevation myocardial infarction prinzmetal's angina | Prinzmetal's Angina]]  |  [[Unstable angina / non ST elevation myocardial infarction cardiovascular syndrome x | Cardiovascular Syndrome X]]
+'''[[Unstable angina / non ST elevation myocardial infarction future or investigational therapies|Future or Investigational Therapies]]'''
+====Contraindicated medications====
+{{MedCondContrAbs|MedCond = Unstable angina|Dalteparin|Fingolimod|Levothyroxine}}
+==Case Studies==
+[[Unstable angina / non ST elevation myocardial infarction case study one|Case #1]]
-==See Also==
+==Related Chapters==
-* [[The Living Guidelines: UA/NSTEMI | The UA / NSTEMI Living Guidelines: Vote on current recommendations and suggest revisions to the guidelines]]
+* [[Acute Coronary Syndrome risk stratification|Acute Coronary Syndrome Risk Stratification]]
 * [[Chronic stable angina]]
 * [[Non ST Elevation Myocardial Infarction]]
 * [[ST Elevation Myocardial Infarction]]
+* [[Coronary Heart Disease]]
+* [[PCI]]
-==Sources==
+==External Links==
-*2011 ACCF/AHA Focused Update Incorporated Into the ACC/AHA 2007 Guidelines for the Management of Patients With Unstable Angina/Non-ST-Elevation Myocardial Infarction: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines<ref name="pmid21444888">{{cite journal |author=Anderson JL, Adams CD, Antman EM, Bridges CR, Califf RM, Casey DE, Chavey WE, Fesmire FM, Hochman JS, Levin TN, Lincoff AM, Peterson ED, Theroux P, Wenger NK, Wright RS |title=2011 ACCF/AHA Focused Update Incorporated Into the ACC/AHA 2007 Guidelines for the Management of Patients With Unstable Angina/Non-ST-Elevation Myocardial Infarction: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines |journal=[[Circulation]] |volume= |issue= |pages= |year=2011 |month=March |pmid=21444888 |doi=10.1161/CIR.0b013e318212bb8b |url=http://circ.ahajournals.org/cgi/pmidlookup?view=long&pmid=21444888 |accessdate=2011-04-08}}</ref>
-* The ACC/AHA 2007 Guidelines for the Management of Patients With Unstable Angina/Non-ST-Elevation Myocardial Infarction <ref name="pmid17692738">{{cite journal |author=Anderson JL, Adams CD, Antman EM, Bridges CR, Califf RM, Casey DE, Chavey WE, Fesmire FM, Hochman JS, Levin TN, Lincoff AM, Peterson ED, Theroux P, Wenger NK, Wright RS, Smith SC, Jacobs AK, Adams CD, Anderson JL, Antman EM, Halperin JL, Hunt SA, Krumholz HM, Kushner FG, Lytle BW, Nishimura R, Ornato JP, Page RL, Riegel B |title=ACC/AHA 2007 guidelines for the management of patients with unstable angina/non-ST-Elevation myocardial infarction: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 2002 Guidelines for the Management of Patients With Unstable Angina/Non-ST-Elevation Myocardial Infarction) developed in collaboration with the American College of Emergency Physicians, the Society for Cardiovascular Angiography and Interventions, and the Society of Thoracic Surgeons endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation and the Society for Academic Emergency Medicine |journal=[[Journal of the American College of Cardiology]] |volume=50 |issue=7 |pages=e1–e157 |year=2007 |month=August |pmid=17692738 |doi=10.1016/j.jacc.2007.02.013 |url=http://linkinghub.elsevier.com/retrieve/pii/S0735-1097(07)00511-6 |accessdate=2011-04-11}}</ref>
-==References==
-{{Reflist|2}}
-==External links==
-* [http://www.themdtv.org The MD TV: Comments on Hot Topics, State of the Art Presentations in Cardiovascular Medicine, Expert Reviews on Cardiovascular Research]
 * [http://www.clinicaltrialresults.org Clinical Trial Results: An up to date resource of Cardiovascular Research]
 * [http://hp2010.nhlbihin.net/atpiii/calculator.asp?usertype=pub Risk Assessment Tool for Estimating Your 10-year Risk of Having a Heart Attack] - based on information of the [[Framingham Heart Study]], from the United States [[National Heart, Lung and Blood Institute]]
-* [http://www.nlm.nih.gov/medlineplus/heartattack.html Heart Attack] - overview of resources from [[MedlinePlus]].
+{{WikiDoc Help Menu}}
-* [http://ww2.heartandstroke.ca/Page.asp?PageID=1975&ArticleID=5288 Heart Attack Warning Signals] from the Heart and Stroke Foundation of Canada
+{{WikiDoc Sources}}
-* [http://www.regionalpci-stemi.org/index.html Regional PCI for STEMI Resource Center] - Evidence based online resource center for the development of regional PCI networks for acute STEMI
-* [http://www.stemisystems.org/ STEMI Systems] - Articles, profiles, and reviews of the latest publications involved in STEMI care. Quarterly newsletter.
-* [http://d2b.acc.org/ American College of Cardiology (ACC) Door to Balloon (D2B) Initiative.]
-*[http://www.americanheart.org/heartattack American Heart Association's Heart Attack web site] - Information and resources for preventing, recognizing and treating heart attack.
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