Guidelines

• ESC(2008)STEMI;
• absolute [/relative] contraindications for fibrinolytic therapy
• haemorrhagic stroke or stroke of unknown origin at any time
• ischaemic stroke[/TIA] in the preceeding 6 months
• CNS trauma or neoplasm
• recent major trauma/surgery/head injury (within preceeding 3 weeks)
• GI bleeding within preceeding 1 month
• known bleeding disorder[/oral anticoagulant therapy]
• aortic dissection
• non-compressible punctures (eg liver biopsy, lumbar puncture)
• infective endocarditits
• [pregnancy or <=1wk postpartum]
• [refractory hypertension (BP>180/110)]
• [advanced liver disease]
• [active peptic ulcer]
• [refractory resuscitation]
• ESC(AF)2006;

TIMI Risk Score for UA/NSTEMI

• 1=  5%, e.g. + age ≥ 65 years?
• 2=  8%, e.g. + > 3 Risk Factors for CAD?
• 3=13%, e.g. + known CAD (stenosis ≥ 50%)
• 4=20%, e.g. + ASA use in past 7d
• 5=26%, e.g. + severe angina (≥ 2 episodes w/in 24 hrs)
• 6=41%, e.g. + ST changes ≥ 0.5mm
• 7=41%, e.g. + cardiac marker

Endocarditis

• see 1-Bacterial;

Auscultation

• AR |

ECG

• BMJ(2002): AMI: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1122768;