![]() With either strategy, aspirin therapy (162 to 325 mg per day) should be started as soon as possible and continued indefinitely. 4, 5 Dual antiplatelet therapy is highly recommended in the treatment of STEMI to support primary PCI and fibrinolytic treatment strategies. Table 1 summarizes the medications used to manage ACS. The goal of medical management is to administer fibrinolytic therapy within 30 minutes of first medical contact. If none is available within a 30-minute travel time, medical management should occur in the nearest emergency department. Primary percutaneous coronary intervention (PCI) is the recommended reperfusion method therefore, all efforts should be made to transfer a patient with suspected STEMI to a PCI-capable hospital. 1 Part of the initial assessment also involves obtaining cardiac biomarkers that include troponin (I or T). Electrocardiographic findings that may reflect myocardial ischemia include changes in the PR segment, QRS complex, and the ST segment. Initial care should include a full assessment of clinical symptoms and coronary artery disease risk factors, as well as 12-lead electrocardiography. 4 At the community level, local areas should create and maintain emergency medical service systems that support STEMI care. Post–myocardial infarction care should be closely coordinated with the patient's cardiologist and based on a comprehensive secondary prevention strategy to prevent recurrence, morbidity, and mortality.Īt the individual level, patients should be advised to chew a nonenteric coated aspirin (162 to 325 mg) at first recognition of ACS symptoms, unless they have a history of severe aspirin sensitivity. Fibrinolysis is not recommended in patients with non–ST elevation acute coronary syndrome therefore, these patients should be treated with medical management if they are at low risk of coronary events or if percutaneous coronary intervention cannot be performed. If percutaneous coronary intervention cannot be performed rapidly, patients with ST elevation myocardial infarction can be treated with fibrinolytic therapy. Coupled with appropriate medical management, percutaneous coronary intervention can improve short- and long-term outcomes following myocardial infarction. Rapid reperfusion with primary percutaneous coronary intervention is the goal with either clinical presentation. Diagnosis can be made based on patient history, symptoms, electrocardiography findings, and cardiac biomarkers, which delineate between ST elevation myocardial infarction and non–ST elevation acute coronary syndrome. Family physicians need to identify and mitigate risk factors early, as well as recognize and respond to acute coronary syndrome events quickly in any clinical setting. TIMI risk score for ST-elevation myocardial infarction: A convenient, bedside, clinical score for risk assessment at presentation: An intravenous nPA for treatment of infarcting myocardium early II trial substudy.Acute coronary syndrome continues to be a significant cause of morbidity and mortality in the United States. TIMI risk score accurately risk stratifies patients with undifferentiated chest pain presenting to an emergency department. Lifestyle changes for heart attack prevention.Application of current guidelines to the management of unstable angina and non-ST-elevation myocardial infarction. The TIMI risk score for unstable angina/non-ST elevation MIA method for prognostication and therapeutic decision making. You can learn more about how we ensure our content is accurate and current by reading our editorial policy. Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. Last medically reviewed on March 21, 2018 Your healthcare provider should be able to explain your results in a way that you can easily understand. Talk to your doctor if you have any questions about your TIMI score. keeping cholesterol and blood pressure levels in check.avoiding cigarette smoking and limiting alcohol consumption.You can lower your score, and your risk for a heart-related event, by: For example, if your TIMI score is on the high side, your physician might want to treat your condition more aggressively or pursue other kinds of medical intervention. Your score may help your physician come up with a treatment strategy. Knowing your risk for having a heart attack or other heart-related event can be extremely helpful to your healthcare provider. This means not every person will be given a TIMI score. Doctors typically use the TIMI score on a select group of people with heart conditions that meet a certain criterion. ![]()
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