2014 AHA/ACC Guideline for the Management of Patients With Non–ST-Elevation Acute Coronary Syndromes

Cardiology PGY1 PGY2 PGY3 PGY4

Very Useful statement for taking care of patients with chest pain, not shocking news, but interesting to see in cardiology literature, they appreciate our concerns:

  • Acute ischemia was diagnosed in 22% of patients who presented to the ED with sharp or stabbing pain and in 13% of those with pleuritic pain.
  • Seven percent of patients whose pain was reproduced with palpation had ACS.
  • The relief of chest pain with nitroglycerin is not predictive of ACS.
  • One study reported that sublingual nitroglycerin relieved symptoms in 35% of patients with documented ACS compared with 41% of patients without ACS
  • The relief of chest pain by “gastrointestinal cocktails” (e.g., mixtures of liquid antacids, and/or viscous lidocaine, and/or anticholinergic agents) does not predict the absence of ACS

Link to Guideline