Links To And Excerpts From The 2020 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation

In this post I link to and excerpt from The 2020 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: The Task Force for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation of the European Society of Cardiology (ESC) [PubMed Abstract] [Full Text HTML] [Full Text PDF]. European Heart Journal, Volume 42, Issue 14, 7 April 2021, Pages 1289–1367.

All that follows is excerpted from the above:

Article Contents

• Table of contents
• Abbreviations and acronyms
• 1 Preamble
• 2 Introduction
• 3 Diagnosis
• 3.4 Differential diagnosis
• 4 Risk assessment and outcomes
• 5 Pharmacological treatments
• 6 Invasive treatments
• 7 Myocardial infarction with non-obstructive coronary arteries and alternative diagnoses
• 8 Special populations
• 9 Long-term management of non-ST-segment elevation acute coronary syndrome
• 10 Quality measures
• 11 Management strategy
• 12 Key messages
• 13 Gaps in evidence for non-ST-segment elevation acute coronary syndrome care and future research
• 14 ‘What to do’ and ‘what not to do’ messages
• 15 Supplementary data
• 16 Appendix
• 17 References
• Supplementary data

3.4 Differential diagnosis

Among unselected patients presenting with acute chest pain to the emergency department, disease prevalence can be expected to be the following: 510% STEMI, 1520% NSTEMI, 10% unstable
angina, 15% other cardiac conditions, and 50% non- cardiacdiseases.35,36,39,69,79,8793 Several cardiac and non-cardiac conditions may mimic NSTE-ACS (Table 6).

put in table 6

Conditions that should always be considered in the differential
diagnosis of NSTE-ACS because they are potentially life-threatening but also treatable include aortic dissection, pulmonary embolism, and tension pneumothorax. Echocardiography should be performed urgently in all patients with haemodynamic instability of suspected cardiovascular origin. Takotsubo syndrome has recently been

4 Risk assessment and outcomes

5 Pharmacological treatments

Start here on PDF p 21.