 Welcome back to ACS Part 4. In this video, we'll discuss the treatment for STEMI and non-STEMI. Keep in mind that there will be lots of new medications that are constantly on the rise in this field. And therefore, this video will mostly talk about the principles rather than specific medications. Here are the five overarching principles. Patients in STEMI should be given oxygen, an anti-platelet agent, an antithrombin agent, their vessel needs to be opened up quickly, and then there are other treatment for symptoms only. Let's go into each of these. Supplemental oxygen should be given to patients to achieve a saturation above 92%. Next, anti-platelet agent. Anti-platelet includes aspirin, clopidogrel, or new drug called tecagrelor. Depending on the patient, some cardiologists will also put the patient on a glycoprotein 2B3A inhibitor. Next, antithrombotic agents. They include unfractionated heparin. Other choices include low molecular weight heparin. They can also include fonda parenox. Again, it can be very institution-specific so check with your staff. The main treatment for ST elevation MI is to open the vessel. This is done by percutaneous coronary intervention, or PCI. In PCI, a small guide wire is inserted into the site of the blocked coronary artery. A balloon is inflated. A stent is kept in place in the same spot to allow for regular flow through the coronary artery. This is an image taken during the angiogram. As the dye is running through the coronary artery, you can see that there is a section that has a much narrower lumen. Now here, the guide wire is inserted and the balloon is inflated across the blocked section. You can see on the left is the before shot during the angiogram, the narrow lumen. And on the right, that lumen has opened up. If the patient has multiple blocked arteries and if these lesions are not amenable to PCI, they would be candidates for coronary artery bypass graft surgery. There are also other symptom treatment we give for patients who is having a ST elevation MI. They include morphine and nitrates. Both are used for symptom relief only. For a non-stemmy, we have a way to risk stratify the patient. One of the scores is called the timmy risk score. These are used in patients with a non-diagnostic ACG or a normal initial set of cardiac enzymes. This score looks at multiple risk factors to increase the risk of death, MI, or ischemia needing revascularization in the next 14 days. Each of these will give the patient a point. First one is age 65 or older. Second one include more than three known coronary artery disease risk factors such as smoking, diabetes, hypercholesteroemia, hypertension, and family history of coronary artery disease. Next point is known coronary artery disease. Whether they have used aspirin in the past week, severe angina meaning more than two episodes in the past 24 hours. ST segment changes that's more than half a millimeter and positive cardiac markers. The higher the score, the more aggressive the treatment should be. The treatment for a non-stemmy is very similar to the principles we have for stemmy. They include oxygen, anti-platelet such as aspirin, clopidogrel, tachycagrelor, and glycoprotein 2B3A inhibitor in the right patient. Antithrombotic agents such as heparin, lomelagoid-weight heparin, and other agents. Certain patients with N-stemmy will undergo either PCI or eventually coronary artery bypass grafting. In terms of symptom treatment, it's the same. Nitrates and morphine. In summary, discuss the treatment for N-stemmy and stemmy patients. This is a field of constant research. There are new medication being put into use on a regular basis. Therefore, what you choose at the end will largely base on your institution and what's in the literature at the time. Thank you for watching.