Acute Coronary Syndrome

An elderly male passenger presented to the Medical Centre with severe unstable angina. He was admitted into our critical crew unit and treated according to our clinical guidelines for unstable angina/non-ST elevation myocardial infarct. This included cardiac monitoring, oxygen, intravenous nitrates, LMW heparin, aspirin, clopiogrel and morphine. Unfortunately he subsequently developed worsening pain associated with acute ST elevation. He tested positive for Troponin I and CK-MB. He was immediately thrombolysed with Tenectaplase and responded well with a reduction in pain and reducing ST segments. He continued to improve and was safely debarked to a coronary care unit in the UK the following day.