Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with substernal chest pressure radiating to the [jaw/left arm], associated with dyspnea, diaphoresis, and orthopnea. Symptoms consistent with NSTEMI complicated by acute heart failure, evidenced by elevated cardiac biomarkers and clinical signs of volume overload.
Clinical Examination Findings
General: Patient appears in acute distress, tachypneic. Cardiovascular: Tachycardic, S3 gallop present, JVD noted. Pulmonary: Bilateral crackles at lung bases. Extremities: 2+ pitting edema to the mid-shin.
Treatment Protocol
Initiate ACS protocol: Dual antiplatelet therapy (DAPT), anticoagulation (heparin drip), high-intensity statin, and beta-blockers. Manage HF with IV loop diuretics, nitrates, and ACE inhibitors/ARNI as tolerated. Monitor I/Os, daily weights, and serial cardiac enzymes.