ACUTE CORONARY SYNDROME-ECG DIAGNOSTIC CRITERIA

SUMMARY

1. Directed history & inx.

2. High-risk features: ongoing chest pain > 20 min, reversible ST-segment changes > 0.5 mm, elevated cardiac enzymes, signs of LV dysfunction.

3. Non-diagnostic ECG: repeat the ECG q15-30 min or do continuous monitoring.

4. Possible ACS with non-diagnostic ECG & normal initial serum markers: observe 12hrs. If there is no recurrence & 2nd set of markers is negative, perform further risk stratification with a stress test.

5. Definitive ACS: if there is ST-segment elevation or new LBBB, consider emergent reperfusion.

Reference(s)

Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. Get it on Amazon.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].