文档介绍：The Management of Patients with Unstable Angina and Non-ST-Segment Elevation Myocardial Infarction
ACC/AHA Pocket Guidelines
November, 2002
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ACC/AHA Classifications Expert Opinion and mendations
Class I Conditions for which there is evidence and/or general agreement that a given procedure or treatment is beneficial, useful, and effective
Class II Conditions for which there is conflicting evidence and/or a divergence of opinion about the usefulness/efficacy of a procedure or treatment
Class IIa weight of evidence/opinion is in favor of usefulness/efficacy
Class IIb usefulness/efficacy is less well established by evidence/opinion
Class III Conditions for which there is evidence and/or general agreement that the procedure/treatment is not useful/effective and in some cases may be harmful
II. Initial Evaluation and Management
A. Clinical Assessment
B. Early Risk Stratification C. Immediate Management
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A. Clinical Assessment mendation for Initial Triage
Class I
1. Patient with possible ACS should not be evaluated solely over the telephone but should be referred to a facility that allows evaluation by a physician and the recording of a 12-lead electrocardiogram (ECG)
2. Patients with a suspected ACS with chest fort at rest for >20 minutes, hemodynamic instability, or recent syncope or presyncope should be strongly considered for immediate referral to an emergency department or a specialized chest pain unit
B. Early Risk Stratification mendation
Class I
1. Patients who present with chest fort should undergo early risk stratification that focuses on anginal symptoms, physical findings, ECG findings, and biomarkers of cardiac injury
2. A 12-lead ECG should be obtained immediately in patients with ongoing chest fort
B. Early Risk Stratification mendation
Class I
3. Biomarkers of cardiac injury should be measured in all patients who present with chest fort consistent with ACS. A cardiac -specific troponin is the preferred marker, an