Assessment & Plan (short)
# Myocardial Infarction - NSTEMI
Patient presents with chest discomfort with concern for NSTE-ACS given troponin elevation and EKG with ***.
Dx
- GRACE score ***
- Trop, EKG, with 4-6hr repeat
- CBC, BMP, VBG
- CXR
- CPO, Telemetry
- Consider DDimer, BP in 4 extremities
- Consider urgent to emergent cath if with refractory chest pain, new heart failure, new MR murmur, shock, or sustained VT.
Tx
- s/p ASA 325 mg, Atorvastatin 80 mg
- P2Y12 inhibitor per institutional preference
- Metoprolol tartrate 12.5 q8h if not in heart failure/shock
- ACEi within 24hrs.
- Heparin gtt (ACS orderset)
- Nitroglycerin 0.4 mg SL q5m x 3 PRN -> Nitroglycerin gtt if refractory
- Avoid morphine
Organ systems
Medical field
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Originally created: March 3, 2020 by Eric Lee
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