Non ST Elevation Myocardial Infarction: Treatment

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]

Any recommendations found on these pages are for education use only. WikiDoc is not a substitute for a licensed healthcare provider. Please see the disclaimers page for important information regarding limitations of the information found here. In suggesting edits to the guidelines, Wikidoc suggests that the following classification scheme be used. Read more about the classification scheme used by the ACC / AHA Guidelines Committee here.

v t e Electrocardiography
Overview	History of the EKG • EKG interpretation basics • Normal sinus rhythm
EKG Complexes	P wave • QRS complex • ST Segment • T wave • T wave alternans • Tombstone T wave • U wave Osborn wave • H wave • K wave • Delta wave NSSTW changes
EKG Intervals	PR Interval • QRS Interval • ST Interval • QT Interval
Conduction System & Bradycardia	Cardiac pacemaker • SA node • AV node• Bundle of His • Purkinje fibers • Sinus bradycardia • First Degree AV Block • Second Degree AV Block • Complete or Third-Degree AV Block • Concealed conduction • AV Junctional Rhythms • LBBB • LAHB • LPHB • RBBB • Trifascicular block
Atrial Arrhythmias	Sinus tachycardia • Premature Atrial Contractions (PACs) • Ectopic Atrial Rhythm • Paroxysmal Atrial Tachycardia (PAT) • Paroxysmal Atrial Tachycardia (PAT) with Block • Multifocal Atrial Tachycardia (MAT) • Atrial Flutter • Atrial Fibrillation • Wandering atrial pacemaker
Ventricular Arrhythmias	Differential Diagnosis of Tachycardia with a Wide QRS Complex • Accelerated Idioventricular Rhythm • Ventricular Parasystole • Premature Ventricular Contractions (PVCs) • Ventricular tachycardia • Ventricular Fibrillation • Sudden cardiac death
EKG Abnormalities in Disease States	Hypertrophy & Dilatation • Right atrial enlargement • Left atrial enlargement • Biatrial enlargement • Left Ventricular Hypertrophy • Right Ventricular Hypertrophy • Biventricular Hypertrophy • Acute myocardial infarction • NSTEMI • STEMI • Tombstone ST elevation • Right ventricular myocardial infarction • Atrial infarction Pre-excitation Syndromes • Wolff-Parkinson-White Syndrome • Lown Ganong Levine Syndrome • Mahaim Type Preexcitation Cardiomyopathies • Arrhythmogenic Right Ventricular Dysplasia • Dilated Cardiomyopathy • Hypertrophic Cardiomyopathy Drug Effects on the EKG • Adenosine • β-blockers • Digitalis • Quinidine • Procainamide • Disopyramide • Lidocaine • Tocainide and Mexiletine • Phenytoin • Encainide, Flecainide and Propafenone • Amiodarone • Bretylium • Ca Channel Blockers • Phenothiazines • Tricyclic Antidepressants • Lithium Congenital Heart Disease • Dextrocardia • Atrial Septal Defect • Ventricular Septal Defect • Tetralogy of Fallot • Conjoined Twins or Siamese Twins • Congenital heart block Electrolyte Disturbances • Hyperkalemia • Hypokalemia • Hypercalcemia • Hypocalcemia • Nonspecific Changes Other Heart Diseases • Pericarditis • Myocarditis • Tamponade • Heart Transplantation • Sick Sinus Syndrome • Long QT Syndrome Inherited Disease • Brugada Syndrome Systemic Diseases • CNS Disease • Cardiac Tumors Heart Transplantation • EKG Changes in patient with Heart Transplantation Exogenous Effects • Hypothermia • Chest Trauma • Insect Bites • Electric Injuries
Technical Issues and Potential Errors in Interpretation	Artifacts • Lead Placement Errors • The EKG in a Patient with a Pacemaker • EKG in athletes

Non ST Elevation Myocardial Infarction: Treatment

Recommendations for Immediate Management [1] [2]

CLASS I

CLASS IIa

Recommendations for Anti Ischemic Therapy [1] [2]

CLASS I

CLASS IIa

CLASS IIb

CLASS III

Recommendations for Antiplatelet Therapy [1] [2]

CLASS I

CLASS IIa

CLASS IIb

CLASS III

Recommendations for Anticoagulant Therapy [1] [2]

CLASS I

CLASS IIa

Recommendations for Additional Management Considerations for Antiplatelet and Anticoagulant Therapy [1] [2]

CLASS I

CLASS IIa

CLASS IIb

CLASS III

Recommendations for PCI [1] [2]

CLASS I

CLASS IIa

CLASS IIb

CLASS III

Recommendations for CABG [1] [2]

CLASS I

CLASS IIa

CLASS IIb

CLASS III

Initial Conservative versus Initial Invasive Strategies [1] [2]

CLASS I

CLASS IIb

CLASS III

Risk Stratification Before Discharge [1] [2]

CLASS I

Recommendations for Medical Regimen and Use of Medications [1] [2]

CLASS I

Recommendations for Beta Blockers Therapy [1] [2]

CLASS I

CLASS IIa

Recommendations for Inhibition of the Renin-Angiotensin-Aldosterone System [1] [2]

CLASS I

CLASS IIa

CLASS IIb

Recommendations for Nitroglycerin Therapy [1] [2]

CLASS I

Recommendations for Calcium Channel Blockers Therapy [1] [2]

CLASS I

Recommendations for Warfarin Therapy [1] [2]

CLASS I

CLASS IIb

Recommendations for Lipid Management [1] [2]

CLASS I

CLASS IIa

CLASS IIb

Recommendations for Blood Pressure Control [1] [2]

CLASS I

Recommendations for Diabetes Mellitus Management [1] [2]

CLASS I

Recommendations for Smoking Cessation [1] [2]

CLASS I

Recommendations for Weight Management [1] [2]

CLASS I

Recommendations for Physical Activity [1] [2]

CLASS I

CLASS IIb

Recommendations for Patient Education [1] [2]

CLASS I

Recommendations for Influenza Vaccination [1] [2]

CLASS I

Recommendations for Depression [1] [2]

CLASS IIa

Recommendations for Non steroidal Anti-Inflammatory Drugs Use [1] [2]

CLASS I

CLASS IIa

CLASS IIb

CLASS III

Recommendations for Immediate Management ^[1] ^[2]

Recommendations for Anti Ischemic Therapy ^[1] ^[2]

Recommendations for Antiplatelet Therapy ^[1] ^[2]

Recommendations for Anticoagulant Therapy ^[1] ^[2]

Recommendations for Additional Management Considerations for Antiplatelet and Anticoagulant Therapy ^[1] ^[2]

Recommendations for PCI ^[1] ^[2]

Recommendations for CABG ^[1] ^[2]

Initial Conservative versus Initial Invasive Strategies ^[1] ^[2]

Risk Stratification Before Discharge ^[1] ^[2]

Recommendations for Medical Regimen and Use of Medications ^[1] ^[2]

Recommendations for Beta Blockers Therapy ^[1] ^[2]

Recommendations for Inhibition of the Renin-Angiotensin-Aldosterone System ^[1] ^[2]

Recommendations for Nitroglycerin Therapy ^[1] ^[2]

Recommendations for Calcium Channel Blockers Therapy ^[1] ^[2]

Recommendations for Warfarin Therapy ^[1] ^[2]

Recommendations for Lipid Management ^[1] ^[2]

Recommendations for Blood Pressure Control ^[1] ^[2]

Recommendations for Diabetes Mellitus Management ^[1] ^[2]

Recommendations for Smoking Cessation ^[1] ^[2]

Recommendations for Weight Management ^[1] ^[2]

Recommendations for Physical Activity ^[1] ^[2]

Recommendations for Patient Education ^[1] ^[2]

Recommendations for Influenza Vaccination ^[1] ^[2]

Recommendations for Depression ^[1] ^[2]

Recommendations for Non steroidal Anti-Inflammatory Drugs Use ^[1] ^[2]

Recommendations for Hormone Therapy ^[1] ^[2]

Recommendations for Antioxidant Vitamins and Folic Acid Use ^[1] ^[2]

Recommendations for Post discharge Follow-Up ^[1] ^[2]

Recommendations for Cardiac Rehabilitation ^[1] ^[2]

Recommendations for UA/NSTEMI in Women ^[1] ^[2]

Recommendations for UA/NSTEMI in Diabetic Patients ^[1] ^[2]

Recommendations for UA/NSTEMI in Post CABG Patients ^[1] ^[2]

Recommendations for UA/NSTEMI in Elderly ^[1] ^[2]

Recommendations for UA/NSTEMI in Chronic Kidney Disease ^[1] ^[2]

Recommendations for UA/NSTEMI in Drug and Substance Abusers ^[1] ^[2]

Recommendations for Prinzmetal’s Angina ^[1] ^[2]

Recommendations for patients with Cardiovascular Syndrome X ^[1] ^[2]