Immediate medical stabilization in suspected ACS aims to relieve ischemic chest pain, reduce myocardial oxygen demand, limit infarct expansion, and stabilize ruptured coronary plaques.
Provides analgesia and venodilation (reserved for intractable pain; use judiciously as it may delay P2Y12 antiplatelet absorption).
Indicated ONLY if SpO2 < 90% or patient in respiratory distress (hyperoxia can induce coronary vasoconstriction).
Sublingual or IV spray to reduce preload and coronary vasospasm (CONTRAINDICATED in right ventricular infarction or recent PDE-5 inhibitor use).
162-325 mg non-enteric chewed immediately for rapid irreversible COX-1 inhibition and antiplatelet effect.
Oral cardioselective beta-1 blocker (Metoprolol) within 24h to reduce heart rate and myocardial work (avoid if acute HF or heart block).
Initiated within 24 hours to prevent adverse ventricular remodeling, especially in anterior STEMI or EF < 40%.
Dual antiplatelet therapy (DAPT) with Clopidogrel, Ticagrelor, or Prasugrel alongside aspirin.
Atorvastatin 80 mg or Rosuvastatin 40 mg for pleiotropic plaque stabilization and anti-inflammatory action.