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Acute Coronary Syndrome (ACS): OverviewFeature STEMI NSTEMI Unstable AnginaClinical PresentationChest Pain Severe, crushing, >30 min Severe, may be prolonged New onset, worsening, or at restRadiation May radiate to arm, jaw, back Similar to STEMI Similar to STEMIAssociated Symptoms Dyspnea, nausea, diaphoresis Similar to STEMI Similar but may be less severeHemodynamic Status May have signs of shock Usually stable Usually stableDiagnostic FindingsECG Changes ST-segment elevation ST depression or T wave inversion May be normal or have T wave changesCardiac Biomarkers Elevated (Troponin, CK-MB) Elevated NormalInitial ManagementOxygen If SpO2 <94% If SpO2 <94% If SpO2 <94%Aspirin 300mg chewed 300mg 300mgPain Relief Morphine IV Morphine IV if needed Sublingual nitratesAntiplatelet Clopidogrel or Ticagrelor loading dose Clopidogrel or Ticagrelor loading dose Consider ClopidogrelAnticoagulation Heparin or Enoxaparin Heparin or Enoxaparin Consider based on riskDefinitive TreatmentPrimary Intervention Immediate PCI (<90 min) or Thrombolysis if PCI unavailable Early invasive strategy (within 24-72 hours) Risk stratification, consider early invasive strategyIf PCI Delayed Consider thrombolysis Medical management Medical managementSecondary PreventionMedications Dual antiplatelet therapy, statin, beta-blocker, ACE inhibitor Similar to STEMI Similar to STEMILifestyle Changes Smoking cessation, diet modification, exercise, stress management Similar to STEMI Similar to STEMICardiac Rehabilitation Recommended Recommended RecommendedFollow-upOutpatient Care Close follow-up, echocardiogram, cardiac rehab Similar to STEMI Regular follow-up, stress testing if indicated