Treatment For Unstable Angina

Question 1

Define Low risk Unstable Angina -UA

Answer 1

Increased frequency of Angina compared to baseline

pain resolves <20 Min

Question 2

Treatment for low risk UA

Answer 2

Aspirin, O2, BB, Sublingual NTG PRN

Question 3

Define IM risk UA

Answer 3

Rest pain >20 Min Now resolved 
Nocturnal angina
Pain resolved with Nitroglycerin 
Symmetric T wave inverversion 
or St depr <1mm

Question 4

Tx for IM risk UA

Answer 4

Add long acting Nitro drug like isosorbide dinitrate
Consider LMW-heparin
+ ASA, O2, BB, Sublingual NTG

Question 5

Define High Risk UA

Answer 5

Pain does not resolve
ST depression > 1mm
+ Troponin or CK-MB (NSTEMI)
+ acute pulmonary edema or S3

Question 6

TX for High Risk UA

Answer 6

Add LMW heparin

Nitro Drip if pain continues

Question 7

Tx for High RIsk UA if enzymes + or St depression >1mm

Answer 7

Add GP 2B-3A antagonist

Clopidogrel can be added for NSTEMI or if stent is placed during cath