Acute Coronary Syndromes Algorithm

Question 1

immediate general treatment for syndromes suggestive of ischemia or infarction

Answer 1

• aspirin 162-325mg

- O2 if sat

Question 2

immediate assessment for syndromes suggestive of ischemia or infarction

Answer 2

• check vitals
• IV access
• physical exam
• activate cath lab
• cardiac markers
• CXR (

Question 3

EKG interpretation can be 1 of 3 things

Answer 3

1. STEMI
2. high-risk unstable angina/NSTEMI
3. low-/intermediate-risk ACS

Question 4

if EKG shows STEMI, time of onset for acute intervention?

Answer 4

less than 12 hours

Question 5

if EKG shows STEMI, and time of onset is less than 12 hours, what are the reperfusion goals?

Answer 5

• door-to-balloon inflation (PCI) less than 90 minutes

- door-to-needle (fibrinolysis) less than 30 minutes