Características del electrocardiograma y la angiografía en el síndrome coronario agudo sin desplazamiento del s-t

Richard Sera Blanco, Moraima García Díaz, Renán Hernández Núñez, Pedro Alonso Oviedo

Texto completo:

PDF HTML

Resumen

Se realizó un estudio longitudinal, prospectivo, descriptivo, con 50 pacientes ingresados en la unidad de emergencias médicas del hospital general “Leopoldito Martínez”, de San José de las Lajas, con el diagnóstico de síndrome coronario agudo sin elevación del segmento S-T en el electrocardiograma (SCA sin S-T), que incluye a los pacientes con angina inestable (AI) e infarto agudo del miocardio sin onda (IMANQ), en el período comprendido desde el 1ro de enero de 2005, hasta el 31 de marzo de 2006. Todos los pacientes fueron estudiados según las siguientes variables: edad, sexo, factores de riesgo, manifestaciones electrocardiográficas y localización angiográfica de las lesiones de las arterias coronarias. Los resultados mostraron una mayor prevalencia del sexo masculino y mayor de 60 años entre los pacientes con SCA sin S-T. Los factores de riesgo más frecuentes para la enfermedad de arterias coronarias fueron el hábito de fumar, la hipertensión arterial y la cardiopatía isquémica previa, todos de mayor incidencia también en el sexo masculino. Más de dos tercios de los pacientes tuvieron manifestaciones electrocardiográficas, siendo el infradesnivel del S-T y la onda t invertida las mas frecuentes, estas predominaron en el sexo masculino. El 90% de los pacientes tuvieron lesiones angiográficas coronarias, siendo la enfermedad de dos vasos la mas frecuente, seguida por la enfermedad de un solo vaso coronario.

Palabras clave

coronariopatía; angiografía; electrocardiografía

Referencias

Joint European Society of Cardiology, American College of Cardiology Committee. Myocardial infarction redefined: a consensus document of the Joint European Society of Cardiology/American College of Cardiology Committee for the redefinition of myocardial infarction. Eur Heart J 2000; 21: 1502-13.

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; 2003:13.

Nourjah P. National Hospital Ambulatory Medical Care Survey: 2004 emergency department summary. Hyattsville , MD : National Center for Health Statistics; 2004:304.

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: 1.009-1.018.

Ohman EM, Armstrong PW, Christenson RH. Cardiac troponin T levels for risk stratification in acute myocardial ischemia. N Engl J Med 2003; 335: 1.333-1.341.

Moliterno D, Sgarbosa E, Armstrong P. A major dichotomy in unstable angina outcome: ST depression vs Twave inversion-GUSTO II results. J Am Coll Cardiol 2003; 27: 182A.

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: 133-258.

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.

De Servi S, Berzuini C, Poma E. Long-term survival and risk stratification in patients with angina at rest undergoing medical treatment. Intl J Cardiol 2002; 22: 43-50.

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: 1.495-1.502.

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.

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.

Cairns JA, Singer J, Gent M. One year mortality outcomes of all coronary and intensive care unit patients with acute myocardial infaction, unstable angina or other chest pain in Hamilton, Ontario, a city of 375,000 people. Can J Cardiol 2000; 5: 239-46.

Telford AM, Wilson C. Trial of heparin versus atenolol in prevention of myocardial infarction in intermediate coronary syndrome. Lancet. 2000; 1: 1.225-1.228.

Zaret BL, Wackers FJ. Nuclear cardiology. N Engl J Med 2000; 329: 775-783.

Rizik DG, Healy S, Margulis A. A new classification for hospital prognosis of unstable angina pectoris. Am J Cardiol 2001; 75: 993-7.

The TIMI IIIA Investigators. Early effects of tissue-type plasminogen activator addeded to conventional therapy on the culprit coronary lesion in patients presenting with ischemic cardiac pain at rest: results of the Thrombolysis Inhibition in Myocardial Ischemia (TIMI IIIA)

Trial. Circulation 1993; 87: 38-52.

Luchi RJ, Scott SM, Deupree RH. Comparison of medical and surgical treatment for unstable angina pectoris: results of a Veterans Administration Cooperative Study. N Engl Med 2001; 316: 977-84.

Alison HW, Russell ROJ, Mantle JA, Kouchoukos NT, Moraski RE, Rackley CE. Coronary anatomy and arteriography in patients with unstable angina pectoris. Am J Cardiol 2002; 41: 204-9.

Roberts W. Qualitative and quantitative comparison of amounts of narrowing by atherosclerotic plaques in the major epicardial coronary arteries at necropsy in sudden coronary death, transmural acute myocardial infarction, transmural healed myocardial infarction and unstable angina pectoris. Am J Cardiol 2003; 64: 324-328.

Saner GE, Gobel FL , Salomonowitz E. The disease free wall in coronary atherosclerosis: its relation to the degree of obstruction. J Am Coll Cardiol 2003; 6: 1.096-1.099.

Skolumsky R. W, Swowiecz A. P, Hansdt R. L, Kanet T. W. Risk factors and angiographics lesions in the acute coronary syndrome. Am J Card 2002; 456-8.

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 1992; 45: 621-6.

Enlaces refback

  • No hay ningún enlace refback.


Copyright (c) 2020 Richard Sera Blanco, Moraima García Díaz, Renán Hernández Núñez, Pedro Alonso Oviedo

Licencia de Creative Commons
Esta obra está bajo una licencia de Creative Commons Reconocimiento-NoComercial 4.0 Internacional.