What is the recommended bolus dose of heparin for acute coronary syndrome (ACS)?

For acute coronary syndrome (ACS), a bolus dose of 4000 units of heparin is commonly recommended. This dosage is based on established protocols aimed at rapidly achieving therapeutic anticoagulation in the setting of ACS. Heparin is an important anticoagulant used to prevent further clot formation and to stabilize existing thrombi in patients experiencing acute coronary events.

This larger initial bolus aims to quickly inhibit the coagulation cascade, which is crucial during the acute phase of coronary ischemia. Following the bolus, a continuous infusion of heparin is typically initiated to maintain the desired levels of anticoagulation.

In clinical practice, the choice of bolus may vary based on individual patient factors, such as their weight, renal function, and the specifics of their clinical presentation, but 4000 units provides a robust starting point that is widely accepted in guidelines for the management of ACS.