NSTE-ACS
Summary
Non-ST-elevation acute coronary syndrome — encompasses unstable angina and NSTEMI, caused by partial coronary thrombosis with subendocardial ischemia. Lacks ST elevation but may show ST depression or T-wave inversion.
Detail
NSTE-ACS results from rupture of an atherosclerotic plaque with subtotal coronary occlusion, leading to subendocardial ischemia without transmural infarction. ECG shows ST depression, T-wave inversion, or may be normal; NSTEMI is distinguished from unstable angina by elevated troponin. Management includes dual antiplatelet therapy (aspirin + P2Y12 inhibitor), anticoagulation (heparin), beta-blockers, statins, and nitrates; high-risk patients (TIMI/GRACE score) undergo early invasive angiography within 24-72 hours. Contrast with STEMI: transmural ischemia requires emergent reperfusion (PCI within 90 minutes). Boards: troponin-positive + no ST elevation = NSTEMI.
Sources
- First Aid for USMLE Step 2 CK 2024
- Pathoma
Reviewed by AnkiBoss editorial — medical student review. Information here is for study reference only and is not medical advice. Spotted an error? Let us know.