guidelines for stressing patient

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obiwan

Attending Physician
15+ Year Member
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do you guys know what the new literature guidelines are in terms of evaluating a patient with chest pain (i know there is some TIMI like guidelines looking at age and other things but not for UA/NSTEMI)

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There is a TIMI score for UA/NSTEMI and for STEMI .

TIMI assess the need for urgent revascularization , there is also other scores like GRACE and there are other risk factors (class I - level of evidence A) not included in TIMI score which necessitate an urgent revascularization.

Typically the patient comes with chest pain , you assess whether they have stemi or nstemi/ua or chronic stable angina based on history/clinical examination , ecg , markers. each has it's own path of management .
If you can't determine , follow up with hx/ex , ecg , markers at 0-4-8 hrs and reassess, if negative stress the patient and if negative stress test discharge.
 
You can look at the guidelines in the aha/acc website but i can't be arsed to look it up for you.
 
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