Evidence-based management of Ischaemic Heart Disease according to Uganda Clinical Guidelines 2023
Uganda Clinical Guidelines 2023 · all from source →
General Adult
Diagnosis
Acute Coronary Syndrome
Prolonged chest pain (left/central), radiating to left arm/neck/back, with sweating, dyspnoea, vomiting, anxiety, tachycardia.
Stable Angina
Tightness/oppression in chest worsening on exertion, relieved by rest, lasting a few minutes.
Investigations
Cardiac enzymes (CPK, troponin), ECG (rest and stress), Echocardiogram.
Emergency Management
Acute Coronary Syndrome (Initial)
Acetylsalicylic acid 300 mg single dose (chewed). Glyceryl trinitrate 500 mcg sublingual. Oxygen if SpO2 <94%. Morphine 2.5-5 mg IV if persisting pain. Simvastatin 40 mg or Atorvastatin 40 mg. Enoxaparin 1 mg/kg SC every 12 hours.
Acute Coronary Syndrome (Maintenance)
When stable: Acetylsalicylic acid 75 mg daily, Atorvastatin 40 mg daily, Beta blocker (Atenolol/Carvedilol), and ACE inhibitor if tolerated.
Stable Angina
Acetylsalicylic acid 75-150 mg daily. Atorvastatin 40 mg daily. Beta blockers (Atenolol 25-100 mg) if not diabetic.
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