General measures
|
Ventilation support to correct hypoxemia and, in part, acidosis |
Optimize intravascular volume |
Sodium bicarbonate only for severe metabolic acidosis (arterial pH less than 7.10 to 7.15) |
Aspirin |
Intravenous heparin |
Possible glycoprotein IIb/IIIa inhibitor with NSTEMI |
Insertion of pulmonary artery catheter |
Specific measures
|
Pharmacologic support
|
Sympathomimetic inotropes (eg, dopamine)
|
Norepinephrine (for refractory hypotension)
|
Mechanical support
|
IABP, usually combined with percutaneous coronary intervention or coronary artery bypass graft surgery or possible thrombolytic therapy
|
Newer devices
|
Left ventricular or biventricular assist devices
|
Percutaneous cardiopulmonary bypass
|
Reperfusion/revascularization
|
Primary percutaneous coronary intervention
|
Coronary artery bypass graft
|
Thrombolytic therapy for patients not receiving PCI in a timely manner
|