2015 ESC指南：非持续性ST段抬高型急性冠脉综合征患者的管理

The leading symptom that initiates the diagnostic and therapeutic cascade in patients with suspected acute coronary syndromes (ACS) is chest pain. Based on the electrocardiogram (ECG), two groups of patients should be differentiated:

(1) Patients with acute chest pain and persistent (20 min) ST-segment elevation. This condition is termed ST-elevation ACS and generally reflects an acute total coronary occlusion. Most patients will ultimately develop an ST-elevation myocardial infarction (STEMI). The mainstay of treatment in these patients is immediate reperfusion by primary angioplasty or fibrinolytic therapy.

(2) Patients with acute chest pain but no persistent ST-segment elevation. ECG changes may include transient ST-segment elevation, persistent or transient ST-segment depression, T-wave inversion, flat T waves or pseudo-normalization of T waves or the ECG may be normal.

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