No ST Depression with Ongoing Pain

Patient with no ST changes still experiencing chest pain

Analgesia (as required)

Senior Review to decide if cardiac chest pain

If chest pain does not appear cardiac, explore other causes and develop management plan according to diagnosis

Patient pain free?

Yes

Follw No ST Depression and Pain Free Pathway

No

Immediate phone call to Cardiology Reg for review and management plan if chest pain deemed to be cardiac in origin

Clopidogrel 300mg (if not contraindicated) (Fondaparinux if patient not going to the cath lab)

ECG every 15 mins until pain free - Troponin 6-9 hours - Cardiac Monitoring

Follw No ST Depression and Pain Free Pathway

Refer to Cardiology if ECG
changes or Troponin up

 

TIMI Risk Score for UA/NSTEMI

TIMI Risk Score for UA/NSTEMI

Age >= 65

>= 3 CAD Risk Factors

Known CAD (Stenosis >= 50%)

ASA Use in Past 7 days

Severe Angina (>= 2 episodes in 24hrs)

EkGST Changes >= 0.5mm

Positive Cardiac Marker

Total:

5% risk at 14 days of: all-cause mortality, new or recurrent MI, or severe recurrent ischemia requiring urgent revascularization.