Unstable angina non ST elevation myocardial infarction: Difference between revisions

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{{Unstable angina / NSTEMI}}
{{Unstable angina / NSTEMI}}
{{CMG}}
{{CMG}}
'''Associate Editor-In-Chief:''' {{CZ}}; Smita Kohli, M.D.; {{NMG}}; [[Varun Kumar]], M.B.B.S.; [[Lakshmi Gopalakrishnan]], M.B.B.S.
'''Associate Editors-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
'''''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
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[[Unstable angina pathophysiology & etiology|Unstable Angina]] | [[Non ST elevation myocardial infarction pathophysiology & etiology|Non-ST Elevation Myocardial Infarction]]
[[Unstable angina pathophysiology & etiology|Unstable Angina]] | [[Non ST elevation myocardial infarction pathophysiology & etiology|Non-ST Elevation Myocardial Infarction]]


==[[Unstable angina risk stratification and prognosis|Risk Factors]]==
==Risk Factors==
[[Unstable angina risk stratification and prognosis|Risk Stratification]] | [[Unstable angina ACC/AHA Guidelines for Early Risk Stratification |Guidelines for Early Risk Stratification]] | [[Unstable angina ACC/AHA Guidelines for Risk Stratification before discharge |Guidelines for Risk Stratification before discharge]]
 
==[[Unstable angina natural history, complications and prognosis|Natural history, Complications and Prognosis]]==


==Diagnosis==
==Diagnosis==
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'''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]]
==[[Unstable angina and complications of bleeding and transfusion|Complications of Bleeding and Transfusion]]==
[[Unstable angina and complications of bleeding and transfusion#Incidence|Incidence]] • [[Unstable angina and complications of bleeding and transfusion#Definitions for bleeding complications|Definitions]] • [[Unstable angina and complications of bleeding and transfusion#Predictors and Causes of Bleeding|Predictors and Causes of Bleeding]] • [[Unstable angina and complications of bleeding and transfusion#Blood Transfusions|Blood Transfusions]] • [[Unstable angina and complications of bleeding and transfusion#Prognosis|Prognosis]] • [[Unstable angina and complications of bleeding and transfusion#Prevention|Prevention]] • [[Unstable angina and complications of bleeding and transfusion#Recommendations|Recommendations]]


==Discharge Care==
==Discharge Care==
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[[Unstable angina / non ST elevation myocardial infarction long-term medical therapy and secondary prevention#ACC / AHA Guidelines - Antiplatelet Therapy(DO NOT EDIT)|Antiplatelet Therapy]] • [[Unstable angina / non ST elevation myocardial infarction long-term medical therapy and secondary prevention#ACC / AHA Guidelines - Beta Blockers(DO NOT EDIT)|Beta Blockers]] • [[Unstable angina / non ST elevation myocardial infarction long-term medical therapy and secondary prevention#ACC / AHA Guidelines - Inhibition Of The Renin-Angiotensin-Aldosterone System(DO NOT EDIT)|Inhibition Of The Renin-Angiotensin-Aldosterone System]] • [[Unstable angina / non ST elevation myocardial infarction long-term medical therapy and secondary prevention#ACC / AHA Guidelines - Nitroglycerin(DO NOT EDIT)|Nitroglycerin Therapy]] • [[Unstable angina / non ST elevation myocardial infarction long-term medical therapy and secondary prevention#ACC / AHA Guidelines - Calcium Channel Blockers(DO NOT EDIT)|Calcium Channel Blockers]] • [[Unstable angina / non ST elevation myocardial infarction long-term medical therapy and secondary prevention#ACC / AHA Guidelines - Warfarin Therapy(DO NOT EDIT)|Warfarin Therapy]]  
[[Unstable angina / non ST elevation myocardial infarction long-term medical therapy and secondary prevention#ACC / AHA Guidelines - Antiplatelet Therapy(DO NOT EDIT)|Antiplatelet Therapy]] • [[Unstable angina / non ST elevation myocardial infarction long-term medical therapy and secondary prevention#ACC / AHA Guidelines - Beta Blockers(DO NOT EDIT)|Beta Blockers]] • [[Unstable angina / non ST elevation myocardial infarction long-term medical therapy and secondary prevention#ACC / AHA Guidelines - Inhibition Of The Renin-Angiotensin-Aldosterone System(DO NOT EDIT)|Inhibition Of The Renin-Angiotensin-Aldosterone System]] • [[Unstable angina / non ST elevation myocardial infarction long-term medical therapy and secondary prevention#ACC / AHA Guidelines - Nitroglycerin(DO NOT EDIT)|Nitroglycerin Therapy]] • [[Unstable angina / non ST elevation myocardial infarction long-term medical therapy and secondary prevention#ACC / AHA Guidelines - Calcium Channel Blockers(DO NOT EDIT)|Calcium Channel Blockers]] • [[Unstable angina / non ST elevation myocardial infarction long-term medical therapy and secondary prevention#ACC / AHA Guidelines - Warfarin Therapy(DO NOT EDIT)|Warfarin Therapy]]  
• [[Unstable angina / non ST elevation myocardial infarction long-term medical therapy and secondary prevention#ACC / AHA Guidelines - Lipid Management(DO NOT EDIT)|Lipid Management]] • [[Unstable angina / non ST elevation myocardial infarction long-term medical therapy and secondary prevention#ACC / AHA Guidelines - Blood Pressure Control(DO NOT EDIT)|Blood Pressure Control]] • [[Unstable angina / non ST elevation myocardial infarction long-term medical therapy and secondary prevention#ACC / AHA Guidelines - Diabetes Mellitus(DO NOT EDIT)|Diabetes Mellitus]] • [[Unstable angina / non ST elevation myocardial infarction long-term medical therapy and secondary prevention#ACC / AHA Guidelines - Smoking Cessation(DO NOT EDIT)|Smoking Cessation]] • [[Unstable angina / non ST elevation myocardial infarction long-term medical therapy and secondary prevention#ACC / AHA Guidelines - Weight Management(DO NOT EDIT)|Weight Management]] • [[Unstable angina / non ST elevation myocardial infarction long-term medical therapy and secondary prevention#ACC / AHA Guidelines - Physical Activity(DO NOT EDIT)|Physical Activity]] • [[Unstable angina / non ST elevation myocardial infarction long-term medical therapy and secondary prevention#ACC / AHA Guidelines - Patient Education(DO NOT EDIT)|Patient Education]] • [[Unstable angina / non ST elevation myocardial infarction long-term medical therapy and secondary prevention#ACC / AHA Guidelines - Influenza Vaccination(DO NOT EDIT)|Influenza Vaccination]] • [[Unstable angina / non ST elevation myocardial infarction long-term medical therapy and secondary prevention#ACC / AHA Guidelines - Depression(DO NOT EDIT)|Depression]] • [[Unstable angina / non ST elevation myocardial infarction long-term medical therapy and secondary prevention#ACC / AHA Guidelines - Nonsteroidal Anti-Inflammatory Drugs(DO NOT EDIT)|Nonsteroidal Anti-Inflammatory Drugs]] • [[Unstable angina / non ST elevation myocardial infarction long-term medical therapy and secondary prevention#ACC / AHA Guidelines - Hormone Therapy(DO NOT EDIT)|Hormone Therapy]] • [[Unstable angina / non ST elevation myocardial infarction long-term medical therapy and secondary prevention#ACC / AHA Guidelines - Antioxidant Vitamins and Folic Acid(DO NOT EDIT)|Antioxidant Vitamins and Folic Acid]]  
• [[Unstable angina / non ST elevation myocardial infarction long-term medical therapy and secondary prevention#ACC / AHA Guidelines - Lipid Management(DO NOT EDIT)|Lipid Management]] • [[Unstable angina / non ST elevation myocardial infarction long-term medical therapy and secondary prevention#ACC / AHA Guidelines - Blood Pressure Control(DO NOT EDIT)|Blood Pressure Control]] • [[Unstable angina / non ST elevation myocardial infarction long-term medical therapy and secondary prevention#ACC / AHA Guidelines - Diabetes Mellitus(DO NOT EDIT)|Diabetes Mellitus]] • [[Unstable angina / non ST elevation myocardial infarction long-term medical therapy and secondary prevention#ACC / AHA Guidelines - Smoking Cessation(DO NOT EDIT)|Smoking Cessation]] • [[Unstable angina / non ST elevation myocardial infarction long-term medical therapy and secondary prevention#ACC / AHA Guidelines - Weight Management(DO NOT EDIT)|Weight Management]] • [[Unstable angina / non ST elevation myocardial infarction long-term medical therapy and secondary prevention#ACC / AHA Guidelines - Physical Activity(DO NOT EDIT)|Physical Activity]] • [[Unstable angina / non ST elevation myocardial infarction long-term medical therapy and secondary prevention#ACC / AHA Guidelines - Patient Education(DO NOT EDIT)|Patient Education]] • [[Unstable angina / non ST elevation myocardial infarction long-term medical therapy and secondary prevention#ACC / AHA Guidelines - Influenza Vaccination(DO NOT EDIT)|Influenza Vaccination]] • [[Unstable angina / non ST elevation myocardial infarction long-term medical therapy and secondary prevention#ACC / AHA Guidelines - Depression(DO NOT EDIT)|Depression]] • [[Unstable angina / non ST elevation myocardial infarction long-term medical therapy and secondary prevention#ACC / AHA Guidelines - Nonsteroidal Anti-Inflammatory Drugs(DO NOT EDIT)|Nonsteroidal Anti-Inflammatory Drugs]] • [[Unstable angina / non ST elevation myocardial infarction long-term medical therapy and secondary prevention#ACC / AHA Guidelines - Hormone Therapy(DO NOT EDIT)|Hormone Therapy]] • [[Unstable angina / non ST elevation myocardial infarction long-term medical therapy and secondary prevention#ACC / AHA Guidelines - Antioxidant Vitamins and Folic Acid(DO NOT EDIT)|Antioxidant Vitamins and Folic Acid]]  
==[[Unstable angina and complications of bleeding and transfusion|Complications]]==
[[Unstable angina and complications of bleeding and transfusion#Incidence|Incidence]] • [[Unstable angina and complications of bleeding and transfusion#Definitions for bleeding complications|Definitions]] • [[Unstable angina and complications of bleeding and transfusion#Predictors and Causes of Bleeding|Predictors and Causes of Bleeding]] • [[Unstable angina and complications of bleeding and transfusion#Blood Transfusions|Blood Transfusions]] • [[Unstable angina and complications of bleeding and transfusion#Prognosis|Prognosis]] • [[Unstable angina and complications of bleeding and transfusion#Prevention|Prevention]] • [[Unstable angina and complications of bleeding and transfusion#Recommendations|Recommendations]]


==Special Groups==
==Special Groups==
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* [http://d2b.acc.org/ American College of Cardiology (ACC) Door to Balloon (D2B) Initiative.]
* [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.
*[http://www.americanheart.org/heartattack American Heart Association's Heart Attack web site] - Information and resources for preventing, recognizing and treating heart attack.
{{Circulatory system pathology}}
{{Electrocardiography}}


[[Category:Cardiology]]
[[Category:Cardiology]]

Revision as of 16:46, 8 July 2011

Unstable angina pectoris
ICD-10 I20
ICD-9 413
DiseasesDB 8695
eMedicine med/133 
MeSH D000787

Acute Coronary Syndrome Main Page

Unstable angina / NSTEMI Microchapters

Home

Patient Information

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

Women
Heart Failure and Cardiogenic Shock
Perioperative NSTE-ACS Related to Noncardiac Surgery
Stress (Takotsubo) Cardiomyopathy
Diabetes Mellitus
Post CABG Patients
Older Adults
Chronic Kidney Disease
Angiographically Normal Coronary Arteries
Variant (Prinzmetal's) Angina
Substance Abuse
Cardiovascular "Syndrome X"

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

Blood Studies
Biomarkers

Electrocardiogram

Chest X Ray

Echocardiography

Coronary Angiography

Treatment

Primary Prevention

Immediate Management

Anti-Ischemic and Analgesic Therapy

Cholesterol Management

Antitplatelet Therapy

Antiplatelet therapy recommendations
Aspirin
Thienopyridines
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

ICD within 90 days of revascularization

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Unstable angina non ST elevation myocardial infarction On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Unstable angina non ST elevation myocardial infarction

CDC onUnstable angina non ST elevation myocardial infarction

Unstable angina non ST elevation myocardial infarction in the news

Blogs on Unstable angina non ST elevation myocardial infarction

to Hospitals Treating Unstable angina non ST elevation myocardial infarction

Risk calculators and risk factors for Unstable angina non ST elevation myocardial infarction

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editors-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]

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

Overview

Epidemiology and Demographics

Pathophysiology and Etiology

Unstable Angina | Non-ST Elevation Myocardial Infarction

Risk Factors

Risk Stratification | Guidelines for Early Risk Stratification | Guidelines for Risk Stratification before discharge

Natural history, Complications and Prognosis

Diagnosis

Differential diagnosis | Initial Therapy | History & Symptoms | Physical Examination | Biomarkers | Electrocardiogram | Chest X-Ray | Echocardiography | Coronary Angiography

Treatment

Pre-hospital Care : Before Onset After Onset

Immediate Management : Immediate Management | Oxygen | Nitrates | Analgesics | Beta Blockers | Calcium Channel Blocker | Inhibitors of Renin-Angiotensin-Aldosterone axis

Antithrombin Therapy : Antithrombin TherapyUnfractionated HeparinLow Molecular Weight HeparinDirect Thrombin InhibitorsFactor Xa InhibitorsLong Term AnticoagulationACC/AHA Guidelines for Anticoagulation

Antitplatelet Agents :AspirinThienopyridinesGlycoprotein IIb/IIIa Inhibitor

Additional Management Considerations for Antiplatelet and Anticoagulant Therapy

Mechanical Reperfusion : Initial Conservative Versus Initial Invasive Strategies PCI CABG

Complications of Bleeding and Transfusion

IncidenceDefinitionsPredictors and Causes of BleedingBlood TransfusionsPrognosisPreventionRecommendations

Discharge Care

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

Long-Term Medical Therapy and Secondary Prevention

Antiplatelet TherapyBeta BlockersInhibition Of The Renin-Angiotensin-Aldosterone SystemNitroglycerin TherapyCalcium Channel BlockersWarfarin TherapyLipid ManagementBlood Pressure ControlDiabetes MellitusSmoking CessationWeight ManagementPhysical ActivityPatient EducationInfluenza VaccinationDepressionNonsteroidal Anti-Inflammatory DrugsHormone TherapyAntioxidant Vitamins and Folic Acid

Special Groups

Women | Diabetic Patients | Post CABG Patients | Elderly | Chronic Kidney Disease | Drug and Substance Abusers | Prinzmetal's Angina | Cardiovascular Syndrome X

See Also

Sources

  • 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[1]
  • The ACC/AHA 2007 Guidelines for the Management of Patients With Unstable Angina/Non-ST-Elevation Myocardial Infarction [2]

References

  1. 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 (2011). "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". Circulation. doi:10.1161/CIR.0b013e318212bb8b. PMID 21444888. Retrieved 2011-04-08. Unknown parameter |month= ignored (help)
  2. 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 (2007). "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 of the American College of Cardiology. 50 (7): e1–e157. doi:10.1016/j.jacc.2007.02.013. PMID 17692738. Retrieved 2011-04-11. Unknown parameter |month= ignored (help)

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