Unstable angina / non ST elevation myocardial infarction and stress (Takotsubo) cardiomyopathy
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2014 AHA/ACC Guideline for the Management of Patients With Non–ST-Elevation Acute Coronary Syndromes (DO NOT EDIT) [1]
Stress (Takotsubo) Cardiomyopathy
| Class I |
| "1.Stress (Takotsubo) cardiomyopathy should be considered in patients who present with apparent ACS and nonobstructive CAD at angiography. (Level of Evidence: C)" |
| "2.Imaging with ventriculography, echocardiography, or magnetic resonance imaging should be performed to confirm or exclude the diagnosis of stress (Takotsubo) cardiomyopathy (Level of Evidence: B)" |
| "3.Patients should be treated with conventional agents (ACE inhibitors, beta blockers, aspirin, and diuretics) as otherwise indicated if hemodynamically stable. (Level of Evidence: C)" |
| "4.Anticoagulation should be administered in patients who develop LV thrombi. (Level of Evidence: C)" |
| Class IIa |
| "1.It is reasonable to use catecholamines for patients with symptomatic hypotension if outflow tract obstruction is not present. (Level of Evidence: C)" |
| "2.The use of an intra-aortic balloon pump is reasonable for patients with refractory shock. (Level of Evidence: C)" |
| "3.It is reasonable to use beta blockers and alpha-adrenergic agents in patients with outflow tract obstruction. (Level of Evidence: C)" |
| Class IIb |
| "1.Prophylactic anticoagulation may be considered to inhibit the development of LV thrombi.(Level of Evidence: C)" |
- ↑ Ezra A. Amsterdam, MD, FACC; Nanette K. Wenger, MD et al.2014 AHA/ACC Guideline for the Management of Patients With Non–ST-Elevation Acute Coronary Syndromes. A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. JACC. September 2014 (ahead of print)