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  • Not Consistent With ACS ? Acs Very Consistent With ACS (Based On Clinical Features and ECG)

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    Vanessa Hermione
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    This document provides guidelines for evaluating and treating patients who may be experiencing acute coronary syndrome (ACS). It recommends clinicians first determine the pre-test probability of ACS based on symptoms and ECG. Serial troponin tests and ECGs should be done upon admission and at 3 and 6 hours. If troponin is below 14 ng/L, ACS is not consistent. Levels between 14-29 ng/L require further evaluation or trending. Over 30 ng/L or a rise of 10 ng/L indicates possible ACS and admission to cardiology. The guidelines note individual clinical discretion is also important.

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    HSTropTalgorithm-V2

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    This document provides guidelines for evaluating and treating patients who may be experiencing acute coronary syndrome (ACS). It recommends clinicians first determine the pre-test probability of ACS based on symptoms and ECG. Serial troponin tests and ECGs should be done upon admission and at 3 and 6 hours. If troponin is below 14 ng/L, ACS is not consistent. Levels between 14-29 ng/L require further evaluation or trending. Over 30 ng/L or a rise of 10 ng/L indicates possible ACS and admission to cardiology. The guidelines note individual clinical discretion is also important.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    12 views1 page

    Not Consistent With ACS ? Acs Very Consistent With ACS (Based On Clinical Features and ECG)

    Uploaded by

    Vanessa Hermione
    This document provides guidelines for evaluating and treating patients who may be experiencing acute coronary syndrome (ACS). It recommends clinicians first determine the pre-test probability of ACS based on symptoms and ECG. Serial troponin tests and ECGs should be done upon admission and at 3 and 6 hours. If troponin is below 14 ng/L, ACS is not consistent. Levels between 14-29 ng/L require further evaluation or trending. Over 30 ng/L or a rise of 10 ng/L indicates possible ACS and admission to cardiology. The guidelines note individual clinical discretion is also important.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
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    of 1

    Not Consistent with ACS ?

    ACS Very Consistent with ACS

    Consider DDx Clinician to formulate pre-test probability (based on clinical features and ECG)

    Troponin generally not ordered Admit Cardiology

    (at clinician’s discretion) Troponin does not r/o UA

    Possible ACS

    Consider SSU admission if meets criteria

    Serial ECG and troponin stat and at 3 and 6


    hours post onset of most significant
    symptoms

    HS Troponin T ≥ 30 ng/L
    HS Troponin T 14 – 29 ng/L
    HS Troponin T < 14 ng/L (99th percentile Or absolute change ≥ 10 ng/L
    URL) If ongoing clinical uncertainty for
    ACS, consider further trending Consider DDx
    At 6 hours, not consistent with AMI
    Consider DDx of other conditions Admit Cardiology if clinical picture
    Serial measurement or further testing at e.g. PE, CCF consistent with ACS
    clinician’s discretion
    Consider outpatient Cardiology
    NOTE: these are guidelines and do not override the
    assessment (+/- Treadmill or CCTA)
    individual responsibility of health professionals to
    make appropriate decisions in the circumstances of
    the individual patients

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