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CardioLogIQ
2023

ESC 2023 Guidelines — Acute Coronary Syndromes

2023 ESC Guidelines for the management of acute coronary syndromes

The 2023 guideline is the first to treat the whole acute coronary syndrome spectrum in a single document. STEMI and non-ST-elevation presentations are no longer separate texts; the recommendations are organised around the clinical decision rather than the entry diagnosis, which is exactly how the exam asks about them.

The areas that generate questions are predictable. Timing of the invasive strategy by risk category. Antithrombotic choice and duration, including de-escalation and the patient who also needs an oral anticoagulant. Complete revascularisation in multivessel disease. MINOCA and the diagnostic work-up it requires. And a set of Class III statements that are tested more often than their length suggests — routine oxygen without hypoxaemia, routine thrombus aspiration, pacing for conduction block that has already resolved.

This bank holds one question per numbered recommendation, each set in a case where the recommendation actually decides the answer. Every option carries its own explanation, so a wrong choice tells you which statement you were working against.

What is in the bank

216 active questions. Class and level follow the recommendation each question is built from.

Class of recommendation

Class I
130
Class IIa
44
Class IIb
20
Class III
22

Level of evidence

Level A
67
Level B
76
Level C
73

Sample questions

Acute coronary syndromes · 2023Class IIILevel A
A 73-year-old woman presents with thirty minutes of crushing chest pain radiating to the left arm. Her electrocardiogram shows ST depression in leads V4 to V6 and her troponin is elevated, confirming a non-ST-elevation infarction. She is breathing comfortably at 16 breaths per minute with no accessory muscle use, her chest is clear, and her oxygen saturation is 96% on room air on repeated readings. She is not distressed by breathlessness. On arrival the nurse routinely applied nasal oxygen at four litres a minute, as is the unit's habit for chest pain. What is appropriate?
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