Print version Management ACS.
|Risk factors: DM, smoker, ↑BP, FHx of CAD, ↑Lipids|
|Score 0-3:||2.5% MACE over next 6/52 » Discharge home|
|Score 4-6:||20.3% MACE over next 6/52 » Refer cardiology|
|Score 7-10:||72.7% MACE over next 6 weeks » Admit cardiology|
- Aspirin (325mg PO then 75mg PO OD)
- Clopidogrel (300mg PO load then 75mg PO OD)
- Avoid clopidogrel if suspected left main stem stenosis
- Heparin - 80U/kg bolus then titrated 18U/kg/h to APTT of 50 to 70s
- Enoxaparin (1mg/kg SC BD). Discuss with cardiology if pre-angio
Cardiology Review in MUH
In the case of urgent clinical problems (unstable arrhythmia, STEMI or NSTEMI with pain) patients should be reviewed by:
09:00 to 17:00 Cardiology registrar if available, medical registrar on call if not.
17:00 to 09:00 Medical registrar on call or city-wide cardiology registrar on call (via switch).
All other problems requiring admission should be referred to the medical team on call. The cardiology Intern should not be called.