A Non–ST-Segment Elevation Myocardial Infarction: An Emergent Condition- Main Role of Emergency Providers and Clinical Pathologists: A Review
Alqahtan, A., Alshareef, S., Al-Hadlaq, Z., Almalki, A., ALHAYYAN, K., ALOUFI, S., Bin Barghash, A., ALMUDHISH, F., ALARAG, M., ALAMRI, A., ALANAZI, S., Alshahrani, S. (2024). A Non–ST-Segment Elevation Myocardial Infarction: An Emergent Condition- Main Role of Emergency Providers and Clinical Pathologists: A Review. EKB Journal Management System, 6(4), 713-724. doi: 10.21608/jmals.2024.425349
Amjad Ali Alqahtan; Sharaf Abdullah A Alshareef; Zaid Abdulrahman Al-Hadlaq; Ayidh yahya Jaber Almalki; KHALID SULAIMAN M ALHAYYAN; SAIF MASAD SAUD ALOUFI; Abdullah Murdhi Bin Barghash; FAHAD RASHED ALMUDHISH; MOHAMMED YAHYA ALARAG; ABDULRAHMAN MARI ALAMRI; SAAD MUSHAWWAH ALANAZI; Safar Ali Alshahrani. "A Non–ST-Segment Elevation Myocardial Infarction: An Emergent Condition- Main Role of Emergency Providers and Clinical Pathologists: A Review". EKB Journal Management System, 6, 4, 2024, 713-724. doi: 10.21608/jmals.2024.425349
Alqahtan, A., Alshareef, S., Al-Hadlaq, Z., Almalki, A., ALHAYYAN, K., ALOUFI, S., Bin Barghash, A., ALMUDHISH, F., ALARAG, M., ALAMRI, A., ALANAZI, S., Alshahrani, S. (2024). 'A Non–ST-Segment Elevation Myocardial Infarction: An Emergent Condition- Main Role of Emergency Providers and Clinical Pathologists: A Review', EKB Journal Management System, 6(4), pp. 713-724. doi: 10.21608/jmals.2024.425349
Alqahtan, A., Alshareef, S., Al-Hadlaq, Z., Almalki, A., ALHAYYAN, K., ALOUFI, S., Bin Barghash, A., ALMUDHISH, F., ALARAG, M., ALAMRI, A., ALANAZI, S., Alshahrani, S. A Non–ST-Segment Elevation Myocardial Infarction: An Emergent Condition- Main Role of Emergency Providers and Clinical Pathologists: A Review. EKB Journal Management System, 2024; 6(4): 713-724. doi: 10.21608/jmals.2024.425349

A Non–ST-Segment Elevation Myocardial Infarction: An Emergent Condition- Main Role of Emergency Providers and Clinical Pathologists: A Review

Journal of Medical and Life Science
Volume 6, Issue 4, December 2024, Pages 713-724    PDF (531.41 K)
Document Type: Original Article
DOI: 10.21608/jmals.2024.425349
Authors
Amjad Ali Alqahtan* 1; Sharaf Abdullah A Alshareef2; Zaid Abdulrahman Al-Hadlaq2; Ayidh yahya Jaber Almalki2; KHALID SULAIMAN M ALHAYYAN3; SAIF MASAD SAUD ALOUFI4; Abdullah Murdhi Bin Barghash3; FAHAD RASHED ALMUDHISH4; MOHAMMED YAHYA ALARAG4; ABDULRAHMAN MARI ALAMRI4; SAAD MUSHAWWAH ALANAZI4; Safar Ali Alshahrani5
1Prince Sultan Cardiac Center, Saudi Arabia
2PRINCE SULTAN MILITARY MEDICAL CITY, Saudi Arabia
3Ministry of Defense Health Services, Hafr Al Batin, Saudi Arabia
4Ministry of Defense, Prince Sultan Air Base, Saudi Arabia
5King Fahad Medical City, Riyadh Second Health Cluster, Saudi Arabia
Abstract
Background: Non-ST-segment elevation myocardial infarction (NSTEMI) is a critical subtype of acute coronary syndrome (ACS) characterized by partial coronary occlusion and elevated cardiac biomarkers. Despite lacking ST elevation on ECG, NSTEMI carries significant morbidity and mortality risks, necessitating prompt diagnosis and management. Emergency providers and clinical pathologists play pivotal roles in early recognition, diagnosis, and intervention.
Aim: This review examines the pathophysiology, diagnostic challenges, and evidence-based management strategies for NSTEMI, emphasizing the collaborative roles of emergency and laboratory medicine teams.
Methods: A synthesis of current guidelines and clinical studies was conducted, focusing on risk stratification (e.g., GRACE, TIMI scores), biomarker interpretation (high-sensitivity troponin), and therapeutic protocols (anticoagulation, revascularization timing).
Results: NSTEMI accounts for 70% of ACS cases, with outcomes heavily influenced by timely troponin testing and ECG interpretation. Key findings include that High-sensitivity troponin assays enable earlier diagnosis (within 2–4 hours) but require serial measurements. Early invasive strategies (<24 hours) reduce mortality in high-risk patients (GRACE score >140). Complications like heart failure (15–20% incidence) and renal dysfunction (25–30%) underscore the need for multidisciplinary care.
Conclusion: Effective NSTEMI management hinges on coordinated efforts between emergency providers (rapid triage), pathologists (biomarker accuracy), and cardiologists (definitive care). Future directions include refined risk assessment tools and personalized therapies.
Keywords
NSTEMI; acute coronary syndrome; troponin; emergency medicine; clinical pathology; risk stratification
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