Browse categories and answer follow-up questions to refine your symptom profile.
Initial priorities
NSTEMI time-critical pathway
ABC stability
If airway compromise, immediate airway management
If SpO2 < 90%, initiate oxygen and titrate to SpO2 90-94%
Monitoring and access
Cardiac monitor
Defibrillator pads for ongoing ischemia or dysrhythmia risk
IV access x2
If shock or vasoactive infusions, arterial line
Early diagnostics
12-lead ECG within 10 minutes
Repeat ECG for recurrent pain or clinical change
Early therapies
Chewed aspirin unless true allergy
Sublingual nitroglycerin if hypertensive ischemic pain and no contraindications
High-risk triggers
If hemodynamic instability, ICU level care and urgent cardiology
SBP < 90 mmHg or requiring vasopressors
Altered mental status
If refractory ischemic pain, urgent cardiology and early invasive strategy
Persistent symptoms despite nitrates and beta-blockade as tolerated
Dynamic ST depression or transient ST elevation
If malignant dysrhythmia, ACLS and cardiology
VT or VF
High-grade AV block with instability
Alternate diagnosis red flags
If tearing back pain or pulse deficit, aortic syndrome evaluation before anticoagulation
CT aorta pathway
If pleuritic pain with hypoxemia or high VTE risk, PE evaluation
CT pulmonary angiography pathway
If fever, pleuritic pain, diffuse ST elevation, myocarditis or pericarditis pathway
SymptomDx is an educational tool for medical professionals. It does not replace clinical judgment. Verify all clinical data and drug dosages with authoritative sources.