Cardiovascular · UKMLA & AKT
Non-ST-elevation acute coronary syndrome (NSTE-ACS)
A free high-yield preview for the UKMLA Applied Knowledge Test, covering how to recognise this condition. The full SA Note notes add investigations, management and complications, with practice questions on this topic.
Key high-yield points
- NSTE-ACS = unstable angina (no myocyte necrosis) + NSTEMI (necrosis confirmed by troponin rise)
- Mechanism: plaque rupture/erosion → partial/intermittent thrombus → subendocardial ischaemia (cf. STEMI: complete occlusion → transmural necrosis)
- ECG cannot distinguish NSTEMI from unstable angina - troponin is the differentiating test
A normal ECG does not exclude NSTE-ACS. Serial ECGs are essential if the first is normal.
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