NSTEMI

Question 1

NSTEMI

Answer 1

Either due to:
complete occlusion of a minor coronary artery
Partial occlusion of a major coronary artery

Question 2

Clinical features

Answer 2

Central crushing chest pain
Occurs at rest
Radiates to arm, jaw, neck etc

Question 3

Investigations

Answer 3

ECG - may be normal, may show ST depression

Cardiac biomarkers - troponins, CK enzymes

Question 4

Troponin (Tn)

Answer 4

Protein marker which helps muscles contract.
Raised levels if heart muscle is damaged, specific
Thus, increase in Tn levels diagnoses MI
However, Tn levels can be +ve in other conditions
May not have time to wait for results
Peaks at 24-48 hours
Better than CK enzymes

Question 5

CK enzymes

Answer 5

Detects heart muscle damage
Also detects skeletal muscle and brain damage
Not reliable
May not have time to wait for results

Question 6

Diagnosis

Answer 6

+ve cardiac biomarkers = NSTEMI

-ve cardiac biomarkers = unstable angina

Question 7

Long term management

Answer 7

Aspirin
Clopidogrel (3 months)
Anticoagulants