15251 - Chest Pain & Chest Pain &...

Info iconThis preview shows pages 1–6. Sign up to view the full content.

View Full Document Right Arrow Icon

Info iconThis preview has intentionally blurred sections. Sign up to view the full version.

View Full DocumentRight Arrow Icon

Info iconThis preview has intentionally blurred sections. Sign up to view the full version.

View Full DocumentRight Arrow Icon

Info iconThis preview has intentionally blurred sections. Sign up to view the full version.

View Full DocumentRight Arrow Icon
This is the end of the preview. Sign up to access the rest of the document.

Unformatted text preview: Chest Pain & Chest Pain & Unstable Angina Unstable Angina Eugene Yevstratov MD Eugene Yevstratov MD Based on UCLA protocol of the management of Chest Pain & Unstable Angina 1 ST elevation > 1 mm in 2 or more contiguous limb or precordial leads 2 Left bundle branch block, not known to be old 3 ECG findings useful for establishing the likelihood of coronary artery disease: ST segment depression > 1 mm Inverted T-waves > 1 mm in two or more contiguous leads Diagnostic criteria for acute Diagnostic criteria for acute myocardial infarction myocardial infarction 1 Chest pain assessment by physician (definite angina, probable angina, probably not angina) 2 Prior myocardial infarction or documented coronary artery disease Number of risk factors (diabetes, smoking, hypercholesterolemia, hypertension, post menopausal) 1 Age The major factors in the initial history The major factors in the initial history and physical exam that relate to the and physical exam that relate to the likelihood of coronary artery disease likelihood of coronary artery disease Likelihood of significant coronary artery Likelihood of significant coronary artery disease in patients with symptoms disease in patients with symptoms suggesting unstable angina suggesting unstable angina Low Likelihood: (e.g., 0.01-0.14) Chest pain, "probably not angina" in patients with one or no risk factors, but not diabetes. T wave flat or inverted < 1 mm. Normal ECG. Intermediate Likelihood: (e.g., 0.15-0.84) "Definite angina" in patients with no risk factors for CAD. High Likelihood: (e.g., 0.85-0.99) Known history of prior MI or CAD. "Definite angina" in male > 60 or females > 70. Transient hemodynamic or ECG changes during pain. ST elevation or depression of > 1 mm. Marked symmetrical T wave inversion in multiple leads. Risk Assessment Risk Assessment Low risk : Nonresting angina with increased frequency, severity, or duration. Angina provoked at a lower threshold. New onset angina 2 weeks to 2 months. Normal or unchanged ECG....
View Full Document

Page1 / 20

15251 - Chest Pain & Chest Pain &...

This preview shows document pages 1 - 6. Sign up to view the full document.

View Full Document Right Arrow Icon
Ask a homework question - tutors are online