Guideline We check our quality standards every August to make sure they are up to date. 18 November 2020. Published date: Statement 3 was amended to reflect that not all people in the population covered will have early invasive intervention and the source guidance references were updated. Last updated: ESC Clinical Practice Guidelines. For more info read the Full Text and the Supplementary Data documents. Non-ST Elevation Acute Coronary Syndromes. This quality standard covers diagnosing and managing acute coronary syndromes in adults (aged 18 and over). © 2020 European Society of Cardiology. Our mission: To reduce the burden of cardiovascular disease. A number of organisations recognise the benefit of this quality standard in improving care. Quality standard [QS68] Learn what screening tests the American Cancer Society recommends, when you should have them, and how they are covered under some types of insurance. The guideline aims to improve survival and quality of life for people who have a heart attack or unstable angina. To get the best experience using our website we recommend that you upgrade to a newer version. Find out how to use quality standards and how we develop them. Reference European Heart Journal, doi/10.1093/eurheartj/ehv320, Reference Web Addenda - doi:10.1093/eurheartj/ehv320, Reference Q&A antithrombotic treatment NSTE-ACS GL - doi:10.1093/eurheartj/ehv407, Reference Q&A myocardial revascularization NSTE-ACS GL - doi:10.1093/eurheartj/ehv408, Reference Q&A diagnosis and risk assessment NSTE-ACS GL - doi:10.1093/eurheartj/ehv409, Reference European Heart Journal (2011) 32, 2999–3054, Association for Acute CardioVascular Care, European Association of Preventive Cardiology, European Association of Cardiovascular Imaging, European Association of Percutaneous Cardiovascular Interventions, Association of Cardiovascular Nursing & Allied Professions, Working Group on Atherosclerosis and Vascular Biology, Working Group on Cardiac Cellular Electrophysiology, Working Group on Pulmonary Circulation & Right Ventricular Function, Working Group on Aorta and Peripheral Vascular Diseases, Working Group on Myocardial & Pericardial Diseases, Working Group on Adult Congenital Heart Disease, Working Group on Development, Anatomy & Pathology, Working Group on Coronary Pathophysiology & Microcirculation, Working Group on Cellular Biology of the Heart, Working Group on Cardiovascular Pharmacotherapy, Working Group on Cardiovascular Regenerative and Reparative Medicine, Guidelines and National Cardiac Societies, Universal definition of myocardial infarction, Unstable angina in the era of high-sensitivity cardiac troponin assays, Number and breakdown of classes of recommendations (Supplementary data), Clinical presentation (Supplementary data), Physical examination (Supplementary data), Biomarkers: high-sensitivity cardiac troponin, Rapid ‘rule-in’ and ‘rule-out’ algorithms, Electrocardiogram indicators (Supplementary data), Clinical scores for risk assessment (Supplementary data), Peri-interventional anticoagulant treatment, Peri-interventional antiplatelet treatment, Post-interventional and maintenance treatment, Pharmacological treatment of ischaemia (Supplementary data), Supportive pharmacological treatment (Supplementary data), Nitrates and beta-blockers (Supplementary data), Managing oral antiplatelet agents in patients requiring long-term oral anticoagulants, Patients with atrial fibrillation without mechanical prosthetic heart valves or moderate-to-severe mitral stenosis undergoing percutaneous coronary intervention or managed (Supplementary data), Patients requiring vitamin K antagonists or undergoing coronary artery bypass surgery, Management of acute bleeding events (Supplementary data), General supportive measures (Supplementary data), Bleeding events on antiplatelet agents (Supplementary data), Bleeding events on vitamin K antagonists (Supplementary data), Bleeding events on non-vitamin K antagonist oral anticoagulants (Supplementary data), Non-access-related bleeding events (Supplementary data), Bleeding events related to percutaneous coronary intervention (Supplementary data), Bleeding events related to coronary artery bypass surgery (Supplementary data) 68, Recommendations for bleeding management and blood transfusion in non-ST-segment elevation acute coronary syndromes for anticoagulated patients, Invasive coronary angiography and revascularization, Routine invasive vs. selective invasive approach (Supplementary data), Pattern of coronary artery disease in non-ST-segment elevation acute coronary syndrome (Supplementary data), How to identify the culprit lesion? It describes high-quality care in priority areas for improvement. The Acute Coronary Syndromes Clinical Topic Collection gathers the latest guidelines, news, JACC articles, education, meetings and clinical images pertaining to its cardiovascular topical area — all in one place for your convenience. All rights reserved. This quality standard is endorsed by NHS England as required by the Health and Social Care Act (2012). Acute coronary syndromes are medical emergencies that include myocardial infarction (heart attack) and unstable angina (unexpected, severe chest pain). Acute coronary syndrome is a medical term used to describe problems that occur when there isn’t enough blood flow to the heart. (Supplementary data), Fractional flow reserve, instantaneous wave-free ratio, and other resting indices (Supplementary data), Patients who are not candidates for invasive coronary angiography, Patients with coronary artery disease not amenable to revascularization, Percutaneous coronary intervention vs. coronary artery bypass surgery, Management of patients with ongoing myocardial ischaemia, Management of patients with cardiac arrest, Recommendations for coronary revascularization, Thrombocytopenia related to glycoprotein IIb/IIIa inhibitors (Supplementary data), Heparin-induced thrombocytopenia (Supplementary data), Lifestyle management (Supplementary data), Cardiac rehabilitation (Supplementary data), Psychosocial factors (Supplementary data), Environmental factors (Supplementary data), Adherence and sustainability (Supplementary data), Influenza vaccination (Supplementary data), Pharmacological management (Supplementary data), Proton pump inhibitors (Supplementary data), Glucose-lowering therapy in patients with diabetes, Renin-angiotensin-aldosterone system blockers (Supplementary data), Mineralocorticoid receptor antagonist therapy (Supplementary data), Antihypertensive therapy (Supplementary data), Hormone replacement therapy (Supplementary data). Heart attack and unstable angina (sudden chest pain that typically occurs when someone is at rest) are two examples. It ranges from cardiac arrest, electrical or haemodynamic instability with cardiogenic shock (CS) due to ongoing ischaemia or mechanical complications such as severe mitral regurgitation, to patients who are already pain free again at the time of presentation. The 2019 version of the Guidelines introduces a new drug-drug interaction panel and now consists of six main sections, including a general over- view table of all major issues in … Did you know that your browser is out of date? ACS | Skills Assessment Guidelines for Applicants | V6.1 | December 2019 Page 11. In November 2020, this quality standard was updated to reflect the updated NICE guideline on acute coronary syndromes. The leading symptominitiating the diagnostic and therapeutic cascade in patients with suspected ACS is acute chest discomfort described as pain, pressure, tightness, and burning. Cancer Screening Guidelines. Initial management Oxygen should be administered if there is evidence of hypoxia, pulmonary oedema, or continuing myocardial ischaemia; hyperoxia should be avoided and particular care is required in patients with chronic obstructive airways disease. This guideline covers the early and longer-term (rehabilitation) management of acute coronary syndromes. These include ST-segment elevation myocardial infarction (STEMI), non-ST-segment elevation MI (NSTEMI) and unstable angina. A Diploma, Advanced Diploma or Associate Degree qualification is deemed as having a major in computing if at least 50% of the qualification is ICT.