Unstable Angina

Wellen’s

• A reperfusion syndrome
• Don’t necessarily need emergent cath b/c by definition they are not acutely occluded however they are high risk for reocclusion and:
• Pain is not a sensitive marker for reocclusion so they need continuous 12 lead ST monitoring

Treatment

• Dual antiplatelet (ASA + ticagrelor or clopidogrel)
• Anticoagulation (LMWH or UFH)
• Cath within 24h for high risk pts by GRACE score

Indications for emergent cath in UA/NSTEMI

• Hemodynamic instability
• Electrical instability
• Pulmonary edema
• Uncontrolled pain/ischemia