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Etiology and Treatment of Non-ST-Elevation Myocardial Infarction

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According to Anderson et al. (2007), Non-ST Elevation Myocardial Infarction constitutes a clinical syndrome subset of Acute Coronary Syndrome that is usually caused by Cardiovascular Atherosclerotic Disease and is associated with increased risk of cardiac death and subsequent myocardial infarction. It is defined by the electrocardiographic ST-segment depression or prominent T wave inversion and positive biomarkers of necrosis in the absence of ST-segment elevation and in an appropriate clinical setting such as chest discomfort (Anderson et al. 2007; Kalra et al. 2008).   Acute coronary syndrome starts when platelet aggregates clump together and form thrombi from a ruptured arteriosclerotic plaque.   Once the clot occludes the vessels for more than 20 minutes, the myocardial tissue becomes necrotic due to the occlusion (Smeltzer et al.

2009; White et al. 2012).   Due to this, the heart will not be able to pump enough blood to vital organs and tissues leading to shock and eventually death.   Chest pain in NSTEMI lasts longer and is more severe than the pain of unstable angina and can last for 15 minutes if not treated with rest or nitro-glycerine.   The pain may or may not radiate to the arm, neck, back or epigastric area and may also experience dyspnoea, diaphoresis, nausea, and dizziness (Jevon et al.

2008).   Women experiencing ACS may experience misleading symptoms of indigestion, palpitations, nausea, numbness in the hands, and fatigue rather than chest pain (Overbaugh 2009)  The US Department of Health & Human Services (2010) has cited and summarized the guidelines for management and treatment for ACS in the early management of NSTEMI.   The provision of information under the said guideline is to offer patients clear information about the risks and benefits of treatment.

Moreover, assessment of a patient’ s risk of future adverse cardiovascular events should include: full clinical history to note on the familial risks that can aggravate the chances or risks of having the disease or recurrence; complete and detailed physical examination; 12-lead ECG and blood tests for cardiac markers to confirm the diagnosis for further management.    

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