Management of Acute ST-Segment Elevation Myocardial Infarction (STE-ACS) - Flowchart
Management of Acute ST-Segment Elevation Myocardial Infarction (STE-ACS) - Flowchart Management of Acute ST-Segment Elevation Myocardial Infarction (STE-ACS) Management of Acute ST-Segment Elevation Myocardial Infarction (STE-ACS)
Flowchart

Initial assessment

12-lead ECG
Focused history and examination
IV access and pain relief

Initial assessment

12-lead ECG
Focused history and examination
IV access and pain relief

Initial assessment

Initial assessment

12-lead ECG
Focused history and examination
IV access and pain relief



End

End

End

Initial management if STE-ACS confirmed

Aspirin 300 mg PO
Clopidogrel 300 mg PO
IV Beta Blocker
O2 therapy if saturation < 90%

Initial management if STE-ACS confirmed

Aspirin 300 mg PO
Clopidogrel 300 mg PO
IV Beta Blocker
O2 therapy if saturation < 90%

Initial management if STE-ACS confirmed

Initial management if STE-ACS confirmed

Aspirin 300 mg PO
Clopidogrel 300 mg PO
IV Beta Blocker
O2 therapy if saturation < 90%




2

Reperfusion therapy

Primary PCI if onsite or available within 120 minutes from symptom onset

Reperfusion therapy

Primary PCI if onsite or available within 120 minutes from symptom onset

Reperfusion therapy

Reperfusion therapy

Primary PCI if onsite or available within 120 minutes from symptom onset

Reperfusion therapy

Reperfusion therapy if:


Heart failure
Recurrent arrhythmia
Ongoing ischaemia

Reperfusion therapy

Reperfusion therapy if:


Heart failure
Recurrent arrhythmia
Ongoing ischaemia

Reperfusion therapy

Reperfusion therapy

Reperfusion therapy if:


Heart failure
Recurrent arrhythmia
Ongoing ischaemia


Heart failure
Recurrent arrhythmia
Ongoing ischaemia

Time since onset of symptoms?

Time since onset of symptoms?

Time since onset of symptoms?

Time since onset of symptoms?

< 12 h

< 12 h

< 12 h

>12 h

>12 h

>12 h

Reperfusion therapy

If not available or delay >120 min give
IV fibrinolytic therapy

Reperfusion therapy

If not available or delay >120 min give
IV fibrinolytic therapy

Reperfusion therapy

Reperfusion therapy

If not available or delay >120 min give
IV fibrinolytic therapy