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2020 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation

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Last updated:6th Apr 2016
Status: Live
2020 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation


The clinical presentation of acute coronary syndromes (ACS) is broad. 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 leading symptominitiating the diagnostic and therapeutic cascade in patients with suspected ACS is acute chest discomfort described as pain, pressure, tightness, and burning. Chest pain-equivalent symptoms may include dyspnoea, epigastric pain, and pain in the left arm.


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