Summary
Summary Front Door Medicine
Providing all of your emergency medicine needs in one place. Includes trauma, cardiological conditions, respiratory conditions, haematology etc
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MANAGEMENT OFACUTE CORONARY
SYNDROME
Dr Simon Corbett
Consultant Interventional Cardiologist
University Hospital Southampton NHS Foundation Trust
RCP Advanced Medicine 2020
Specialty Breakout Session – Cardiology
10th February 2020
, Conflicts of Interest
• None
• (although I am Topic Advisor on new NICE clinical guideline on ACS which will be released for
consultation this Friday)
, Outline
• Case-based review of contemporary
management of non-ST-elevation ACS
• I’m not covering STEMI
• Diagnostic dilemmas – do high sensitivity
troponin assays help or hinder patient care?
• Which medical therapies should I be using?
• Is there a role for risk assessment?
, Case 1
• 56 year old man
• No regular medications
• Ex-smoker (25 pack year history)
• Woken up with central
constricting chest discomfort at
0330
• Slightly sweaty and nauseated so
calls 999 after 30 minutes
• Given aspirin and GTN by
paramedics
• Pain free on admission to hospital
• HR 78bpm, BP 134/82
• High sensitivity Troponin I level
on admission 187 ng/l (99th
centile 34.2)
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