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Kabilan K. L.: Management and Diagnosis of Acute Coronary Syndrome Types
Jun 2, 2026, 15:28

Kabilan K. L.: Management and Diagnosis of Acute Coronary Syndrome Types

 Kabilan K. L., Long-Term Care Nurse at Al Emeis Hospital, shared a post on LinkedIn:

”ACS is a group of conditions caused by sudden reduction in blood flow to the heart muscle, resulting in acute myocardial ischemia.

Most commonly due to rupture of an atherosclerotic plaque with thrombus formation.

Classification:

STEMI (ST-Elevation Myocardial Infarction):

  •  ST-segment elevation on ECG
  •  Usually complete coronary occlusion
  •  Elevated cardiac biomarkers
  •  Requires immediate reperfusion therapy
  • NSTE-ACS
  •  Partial coronary occlusion
  • Includes

NSTEMI: Elevated troponins

Unstable Angina: No troponin elevation

Clinical Features:

  • Central chest pain/pressure
  •  Radiation to arm, neck, jaw, or back
  •  Dyspnea
  •  Diaphoresis
  •  Nausea and vomiting
  •  Palpitations
  •  Anxiety and dizziness
  •  Hypotension or cardiogenic shock (severe cases)

Investigations :

  • 12-lead ECG
  •  Cardiac biomarkers (Troponin I/T)
  •  Echocardiography
  •  Coronary angiography

Immediate Management:

  •  Oxygen if hypoxic (SpO₂ <90–94percent)
  •  Cardiac monitoring
  •  IV access
  •  Aspirin 300 mg chewed
  •  Nitroglycerin (if not contraindicated)
  •  Analgesia as required
  •  Early cardiology referral

Reperfusion Strategies (STEMI):

  •  Primary PCI (preferred)
  •  Thrombolytic therapy if PCI unavailable within recommended time
  •  Emergency CABG in selected patients

Pharmacological Therapy:

  •  Dual antiplatelet therapy (DAPT)
  •  Anticoagulants
  •  Nitrates
  •  Beta-blockers
  •  ACE inhibitors/ARBs
  •  Statins
  •  Glycoprotein IIb/IIIa inhibitors (selected cases)

Key Point:

Time is myocardium. Early recognition, rapid diagnosis, and prompt reperfusion significantly improve survival and outcomes.”

Kabilan K. L.: Management and Diagnosis of Acute Coronary Syndrome Types

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