Initial treatment of unstable angina (UA)

The initial treatment of  unstable angina (UA) should include

• bed rest, 
• anti-platelet therapy,
• anticoagulation and 
• a ß-blocker. 

Algorithm for risk stratification and treatment of patients with UA/NSTEMI. DM= diabetes mellitus; Rx = treatment. Updated with permission from Braunwald E, Zipes DP, Libby P, eds. Heart Disease: A Textbook of Cardiovascular Medicine. 6th ed. Philadelphia, Pa: W.B. Saunders; 2001:1232–1263.[Source]

WHO criteria for the diagnosis of acute myocardial infarction

The WHO criteria for the diagnosis of acute myocardial infarction (MI) requires the presence of at least two of three elements:

• History of ischaemic-type chest discomfort
• Evolutionary ECG changes
• Rise and fall in serum cardiac markers.

No further time should be wasted before reperfusing an ST elevation MI (STEMI), generally by thrombolysis. In the case of non-ST elevation MI (NSTEMI), the serum cardiac markers become elevated.