Approach
Obtain & review an ECG w/i 10 min of pt arrival & compare w/ prior if available. If pain persists, repeat q15–20min; consider R-sided & posterior leads if high probability w/ initially nl appearing ECG.
• Intervene early w/ IV, O2, & cardiac monitoring
• CXR for all nontrivial CP
• Give ASA 325 mg if considering a cardiac etiology & you do not suspect aortic dissection
• Give NTG for pain
• Obtain PQRST of pain & recheck after pain medication is given
• Obtain CAD hx: Prior MI, CABG, catheterization, stress test, angina
Risk stratify: Age >50, HTN, DM, HL, +FH, smoking, cocaine; use of risk stratification models such as TIMI, GRACE, or PURSUIT can be useful to assist in decision making w/ regard to tx options in pts w/ suspected ACS.
• Always consider immediately life-threatening causes of CP
