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, Page 713-724 PDF (531.41 K) | ||||
Document Type: Original Article | ||||
DOI: 10.21608/jmals.2024.425349 | ||||
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Authors | ||||
Amjad Ali Alqahtan ![]() | ||||
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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