Arq. Bras. Cardiol. 2021; 117(2): 288-289
NSTE-ACS at the Emergency: Can You Guess What is Under the Umbrella?
This Short Editorial is referred by the Research article "Association between Clinical Risk Score (Heart, Grace and TIMI) and Angiographic Complexity in Acute Coronary Syndrome without ST Segment Elevation".
The reasoning behind the often-difficult task of deciding whether, when and how to treat the patient with established Cardiovascular Disease (CVD) might be based on two simple questions: (1) Are we treating an acute event?, and (2) What is my patient at risk of in the future? Whilst the first question implies an expedite straightforward treatment, the second premise depends mostly on risk stratification and, thus, the capability of one to anticipate the likelihood of an event. Withal, the physician often encounters a scenario in which the two questions must be addressed altogether. Accordingly, the response is more likely one of a probability rather than a categorical (yes or no) answer. This is the outline in umbrella diagnoses, as is non-ST segment elevation (NSTE) Acute Coronary Syndromes (ACS).,
There are a multitude of clinical tools in Cardiovascular Medicine– that aid physicians in the decision-making process, often surpassing the “educated guess” in acute settings., However, the use of these tools in NSTE-ACS is particularly challenging for a number of reasons:
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