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High Risk Acute Coronary Syndrome ManagementAka: ST Elevation MI, Q-Wave MI, Myocardial Infarction Protocol
- See Also
- Criteria: Myocardial Infarction
- ST Elevation 1 mm or more in 2 or more contiguous leads
- New Left Bundle Branch Block obscuring ST segments
- Presumed new Left Bundle Branch Block
- Management: Protocol
- Time from Chest Pain onset <12 hours
- Start MI Adjunctive Therapy, do not delay reperfusion
- Immediate Reperfusion Strategy
- Angioplasty with cardiothoracic back-up (preferred)
- Goal within 90 minutes of ED arrival
- Thrombolytic therapy (if Angioplasty not available)
- Goal within 30 minutes of ED arrival
- Efficacy: Comparing Angioplasty with Thrombolytic
- Similar outcomes and complication rates
- Angioplasty preferred if transport delay <1 hour
- Angioplasty with cardiothoracic back-up (preferred)
- Time from Chest Pain onset >12 hours
- Manage as Myocardial Ischemia Protocol
- Time from Chest Pain onset <12 hours
- References
Myocardial Infarction (C0027051) | |
|---|---|
| Definition (MSH) | NECROSIS of the MYOCARDIUM caused by an obstruction of the blood supply to the heart (CORONARY CIRCULATION). |
| Definition (CSP) | gross necrosis of the myocardium, as a result of interruption of the blood supply to the area. |
| Definition (NCI) | Gross necrosis of the myocardium, as a result of interruption of the blood supply to the area, as in coronary thrombosis. |
| Definition (NCI) | Gross necrosis of the myocardium, as a result of interruption of the blood supply to the area, as in coronary thrombosis. |
| Concepts | Disease or Syndrome (T047) |
| ICD9 | 410.9 |
| MSH | D009203 |
| English | AMI, Attack - heart, ATTACK CORONARY, Cardiac infarction, HEART ATTACK, HEART INFARCTION, INFARCT MYOCARDIAL, Infarction of heart, MI, MI - Myocardial infarction, Myocardial Infarct, Myocardial Infarction, Myocardial Infarctions, Myocardial Infarcts |
| Spanish | ataque al corazon, infarto cardiaco, infarto de corazon, infarto de miocardio |
| Parent Concepts | Heart (C0018787), Cardio-vascular Findings: Heart (C0150873), Myocardial Ischemia (C0151744), Coronary Arteriosclerosis (C0010054), Cardiomyopathies (C0878544), Injury of anatomical site (C1264235), Structural disorder of heart (C1290384), Ambiguous concept (C1274012) |
| Sources | AIR, AOD, COSTAR, CSP, CST, DXP, MEDLINEPLUS, MSH, MTH, MTHICD9, NCI, NDFRT, OMIM, SCTSPA, SNOMEDCT Derived from the NIH UMLS (Unified Medical Language System) |
Acute Coronary Syndrome (C0948089) | |
|---|---|
| Definition (MSH) | An episode of MYOCARDIAL ISCHEMIA that generally lasts longer than a transient anginal episode but that does not usually result in MYOCARDIAL INFARCTION. |
| Concepts | Disease or Syndrome (T047) |
| MSH | D054058 |
| English | ACS - Acute coronary syndrome, Acute Coronary Syndrome, Acute Coronary Syndromes |
| Spanish | sindrome coronario agudo |
| Parent Concepts | Myocardial Ischemia (C0151744), Syndrome (C0039082), Cardiomyopathies (C0878544), Acute ischemic heart disease (C1510446), Duplicate concept (C1274013) |
| Sources | MSH, NCI, SCTSPA, SNOMEDCT Derived from the NIH UMLS (Unified Medical Language System) |
