Caracterización del síndrome coronario agudo sin onda q en la unidad de cuidados intensivos
Palabras clave:
cuidados intensivos, coronariopatiaResumen
Fueron caracterizados 50 pacientes atendidos en la unidad de cuidados intensivos con diagn óstico de síndrome coronario agudo sin onda Q patológica (SCANQ), que incluía los diagnósticos de angina inestable, infarto agudo del miocardio con y sin supradesnivel del st que no desarrollaron onda Q, a los que se les realizóangiografía y electrocardiograma entre el 28 de febrero del 2004 hasta el 1ro de marzo del 2006 Los resultados mostraron un predominio del sexo masculino y mayores de 60 años. El 70% tuvieron alteraciones electrocardiográficas; el s-t negativo, el s-t positivo y la onda t invertida fueron las más frecuentes. El 90% de los pacientes tuvo lesiones angiográficas coronarias, la enfermedad de dos vasos fue la predominante, seguida por la de uno y de tres vasos respectivamente. Se recomienda abordar estas entidades como integrantes de un mismo síndrome con el fin de encauzar las pruebas diagnósticas y aplicar la terapéutica más eficaz.
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Ministerio de Salud Pública. Anuario Estadístico de Cuba (monografía en línea). 2005. Acceso: 12 junio 2007.
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Joint European Society of Cardiology, American College of Cardiology Committee. Myocardial infarction redefined. Eur Heart J 2000; 21: 1502-13.
Zareba W, Moss AJ, Raubertas RF. Risk of subsequent cardiac events in stable convalescing patients after first non-Q-wave and Q-wave myocardial infarction. Coron Artery Dis 2003; 5:1009-18.
Kanojia A, Kasliwal R, Seth A, Bhandari S, Kler TS, Bhatia ML. Clinical and
coronary arteriographic features and outcome of recent onset unstable angina. Int J Cardiol 2003; 39:173-80.
De Wood MA, Stifter WF, Simpson CS. Coronary arteriographic findings soon after non-Q wave myocardial infarction. N Engl J Med 1986; 315:417-23.
Braunwald E, Antman EM, Beasley JW. ACC/AHA guidelines for the management of patients with unstable angina/non-ST segment elevation myocardial infarction: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2004; 36:970-1062.
Lee RT, Libby P. The unstable atheroma. Arterioscler Thromb Vasc Biol 2003; 17:1859-67.
Braunwald E, Mark DB, Jones RH. Unstable angina: diagnosis and management Rockville, MD: Agency for Health Care Policy and Research and the National Heart, Lung, and Blood Institute, US Public Health Service, US Department of Health and Human Services. 2002:1. AHCPR Publication 94-0602.
National Center for Health Statistics. Detailed diagnoses and procedures: National Hospital Discharge Survey, 2003. Hyattsville, MD: National Center for Health Statistics. 2003.
Jayes RL, Beshansky JR, D’Agostino RB. Do patients’ coronary risk factor reports predict acute cardiac ischemia in the emergency department?: a multicenter study. J Clin Epidemiol 2003; 45:621-6.
Scanlon P, Faxon D, Audet A. ACC/AHA Guidelines for coronary angiography: a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines. J Am Coll Cardiol 2003; 33:1756-824.
Horwitz LD, Groves BM, editors. Signs and symptoms in Cardiology. Philadelphia: JB Lippincott; 2004.
Mayer S, Hillis LD. Prinzmetal's angina. Clin Cardiol 2000; 21:243.
The platelet receptor inhibition for ischemic syndrome management in patients limited by unstable signs and symptoms (PRISM-PLUS) trial investigators: inhibition 8 of the platelet glycoprotein IIb/IIIa receptor with tirofiban in unstable angina and non-Q-wave myocardial infarction. N Engl J Med. 1998; 338:1488-97.
Cannon CP, McCabe CH, Stone PH. The electrocardiogram predicts one-year outcome of patients with unstable angina and non-Q wave myocardial infarction: results of the TIMI III Registry ECG Ancillary Study. J Am Coll Cardiol 2002; 30:133-40.
Savonitto S, Ardissino D, Granger CB. Prognostic value of the admission
electrocardiogram in acute coronary syndromes. JAMA 2004; 281:707-13.
Hyde TA, French JK, Wong CK. Four-year survival of patients with acute coronary syndromes without ST-segment elevation and prognostic significance of 0.5-mm STsegment depression. Am J Cardiol 2004; 84:379-85.
Papapietro SE, Niess GS, Paine TD. Transient electrocardiographic changes in patients with unstable angina: relation to coronary arterial anatomy. Am J Cardiol 2003; 46:28-33.
Pryor DB, Shaw L, McCants CB. Value of the history and physical in identifying patients at increased risk for coronary artery disease. Ann Int Med 1999; 118:81-90.
Langer A, Freeman MR, Armstrong PW. ST segment shift in unstable angina: pathophysiology and association with coronary anatomy and hospital outcome. J Am Coll Cardiol 2003; 13: 1.495-502.
Kanojia A, Kasliwal R, Seth A, Bhandari S, Kler TS, Bhatia ML. Clinical and
coronary arteriographic features and outcome of recent onset unstable angina. Int J Cardiol 2003; 39:173-80.
Yusuf S, Zucker D, Peduzzi P. Effect of coronary artery bypass graft surgery on survival: overview of 10-year results from randomized trials by the Coronary Artery Bypass Graft Surgery Trialists Collaboration. Lancet. 1994; 344:563–70.