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Incorporating: Acute GP, SDEC, UTC
Acute Coronary Syndrome (ACS)
Please take observations, a salient history and examination and perform an ECG.
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Consider '999' ambulance in:
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Ongoing cardiac-sounding chest pain (despite simple measures such as GTN)
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ST elevation criteria (see below) or new LBBB on ECG
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Haemodynamically unstable
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Consider giving 300mg chewable aspirin.
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ECG criteria for STEMI:
New ST-segment elevation >1mm in two contiguous leads, in all leads except V2 and V3.
In leads V2 and V3, the threshold is:
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>2mm for men >40, or > 2.5mm for men < 40,
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>1.5mm for women
-OR-
New LBBB
Source: American College of Cardiology (ACC), American Heart Association (AHA), ESC, and the World Heart Federation (WHF)
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