Background: Non-ST-elevation myocardial infarction (NSTEMI) is defined as acute coronary injury resulting in ischemia and myocardial infarction. The diagnosis is made based on clinical presentation and non-specific electrocardiogram (ECG) changes including ST-segment depression, T-wave inversions, or other nonspecific findings.1 Based ...
Background: What if we lived in a world where we didn’t call “STEMI alerts”, but instead paged out “OMI alerts”? In the Reperfusion Era of the late 20th century, many large trials showed the benefits of emergent reperfusion therapy, with even ...
Background: Prior to the discovery of thrombolytics, clinicians could only observe their patients completing their myocardial infarctions and then classify them according to whether their subsequent ECGs developed Q waves. When trials showed a clear survival benefit with thrombolytics (especially ...
Background: The 2014 AHA guidelines for the management of NSTEMI, recommend unfractionated heparin with an initial loading dose of 60IU/KG (maximum 4,000 IU) with an initial infusion of 12 IU/kg/hr (maximum 1,000 IU/hr) adjusted per active partial thromboplastin time to maintain ...
Background: Acute coronary syndrome (ACS) is a true spectrum of disease: STEMI, NSTEMI, Unstable Angina (UA), and Stable Angina (SA). The history and physical plus ECG help us to differentiate patients with STEMI from NSTEMI. Classically, STEMI represents complete occlusion ...
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