Acute coronary syndromes (STEMI, NSTEMI, unstable angina)

Meet the patient

A 58-year-old smoker arrives in your resuscitation bay at 3am with an hour of central chest pressure radiating to both arms. He is sweating and breathless, and the first ECG shows ST elevation in II, III and aVF. The nearest PCI centre is 45 minutes away by road. ^[1]

Hold two questions and everything below slots into place. Is the artery occluded? The ECG, recorded and assessed within 10 min of first clinical contact, answers that. Can it be opened in time? The 120-minute threshold from first medical contact decides between primary PCI and fibrinolysis. ^[1]

References24ShowHide

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