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Feature History
Pain Characteristics
Clinical Findings
Presence of any one of the following: pulmonary edema likely due to ischemia; new or worsening mitral regurgitation; S3 or new/worsening rales; hypotension, bradycardia, tachycardia Age > 75 years Angina at rest with transient ST-segment changes > 0.5 mm BBB new or presumed new Sustained VT Elevated cardiac TnT, TnI, or CK-MB
ECG
T wave changes Pathologic Qs or resting ST-segment depression > 1 mm in multiple lead groups (anterior, inferior, lateral) Slightly elevated TnT, TnI, or CK-MB
Cardiac Markers
Normal
Note: BBB-bundle branch block; CABG-coronary artery bypass graft surgery; CAD-coronary artery disease; CK-MB-creatine kinase, MB fraction; CVD-cerebral vascular disease; ECGelectrocardiogram; MI-myocardial infarction; NTG- nitroglycerin; PVD-peripheral vascular disease; TnI-troponin I; TnT- troponin T; UA/NSTEMI-unstable angina/nonST-elevation myocardial infarction; VT-ventricular tachycardia.
*Estimation of risk for adverse events should be done with patients who present with a history and/or signs and symptoms of cardiac ischemia and considered in patient treatment. from Table 7 page e17 of Anderson et. al, ACC/AHA 2007 Guidelines for the Management of Patients With Unstable Angina/Non-ST-Elevation Myocardial Infarction: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Content is meant to illustrate general guidelines and should not be used as practice algorithms.
Adapted