Treatment of ACS

• Unstable Angina & NSTEMI Treatment:

  • percutaneous coronary intervention (PCI) or coronary artery by-pass graft surgery (CABGS) is only routinely offered to those with unstable angina or NSTEMI who are categorised as high risk
  • Surgery in low risk patients added no benefit to the patient in terms of quality of life and prognosis

  
• Unstable Angina & NSTEMI Treatment:

  • In high risk patient’s PCI or surgery offered
  • Interventions of choice is the PCI (balloon angioplasty plus stent – usually treated with a drug eluting substance to repel platelets and prevent thrombus formation on the stent surface)
  • More complex lesions or multiple diffuse lesions are treated with coronary artery bypass surgery

  
• STEMI Treatment:

  • reperfusion (the re-establishment of coronary blood flow) is of paramount importance to the management of a STEMI and will be achieved ideally by performing a primary percutaneous coronary intervention (PPCI) within 90 mins
  • Choice of surgical procedure is dictated by general patient health, size and nature of the atheroma-thrombotic mass and health of other coronary arteries