Acute coronary syndrome refers to symptoms induced by obstruction of coronary arteries. Etiologies of ACS include unstable angina, STEMI or NSTEMI. Heparin is indicated to help break clots (thrombolysis) in cases of non-ST elevation MI (NSTEMI).
Heparin is used as a prophylactic agent against thrombosis or clots in cases where patients are immobile, hypercoagulable or susceptible to serious complications of thrombosis. Examples of this include patients with risk of or previous DVTs, patients undergoing surgery, and immobile patients.
Though thrombolysis is a goal of treatment in pulmonary embolism, another acute method of stabilizing patients is to keep the thrombi from getting bigger. Heparin is used to prevent expansion of these thrombi.
In atrial fibrillation, patients are overwhelmed by disorganized electrical impulses, leading to an arrhythmia and an increased risk of hematologic stasis. Patients who are at an increased risk for stroke and embolism are often anticoagulated with heparin.
Physiologically, pregnant patients may become hypercoagulable, as a physiologic mechanism to prevent post-partum hemorrhage. Heparin does not cross the placenta, and is safe in the developing fetus. Heparin is used as antithrombic treatment both before and during pregnancy, in patients who are hypercoagulable or need prophylaxis.
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