Göğüs Ağrısı İle Acil Servise Başvuran Hastada Öncelikler

Abstract

Acil servise başvuruların önemli bir yüzdesini oluşturan göğüs ağrısında hızlı klinik değerlendirmeye ilave olarak öncelikli ve doğru elektrokardiyografik değerlendirme ile ısrarcı takibin yapılması, mortalite ve morbiditede azalma sağlamaktadır. Bu hastalarda özellikle de elektrokardiyografik değerlendirme öncesinde yapılacak gereksiz ve zaman alıcı tetkiklerden uzak durulmalıdır. 

Keywords

• Acil servis,Elektrokardiyografi,Göğüs ağrısı

Priorities in Patient Presenting to EmergencyDepartment with Chest Pain

Abstract

In addition to rapid clinical evaluation, preferential and right electrocardiographic assessment and also insistent follow up of the complaint of chest pain that constitute a significant percentage of emergency department admission, provides a reduction in mortality and morbidity in the patients admitted to emergency department with chest pain. Unnecessary and time-consuming diagnostic tests should be avoided in this patient population, especially before the electrocardiographic evaluation.

Keywords

• Emergency department,Electrocardiography,Chest pain

References

1. 1. Alpert JS, Thygesen K, Antman E, Bassand JP. Myocardial infarction redefined-a consensus document of The Joint European Society of Cardiology/American College of Cardiology Committee for the redefinition of my o c a r d i a l i n f a r c ti o n . J AmCo llCa r d i o l 2000;36(3):959-69.
2. 2. Braunwald E, Zipes DP, Libby P, editors. Braunwald's heart disease: a textbook of cardiovascular medicine. 7th ed. Philadelphia: W. B. Saunders, 2001:66-69.
3. 3. Task Force Members, Montalescot G, Sechtem U, Achenbach S, Andreotti F, Arden C, Budaj A. et al. 2013 ESC guidelines on the management of stable coronary artery disease: the Task Force on the management of stable coronary artery disease of the European Society of Cardiology. EurHeart J. 2013;34(38):2949-3003.
4. 4. Amsterdam EA, Kirk JD, Bluemke DA, Diercks D, Farkouh ME, Garvey JL, et al. American Heart Association Exercise, Cardiac Rehabilitation, and Prevention Committee of the Council on Clinical Cardiology, Council on Cardiovascular Nursing, and Interdisciplinary Council on Quality of Care and Outcomes Research. Testing of low-risk patients presenting to the emergency department with chest pain: a scientific statement from the American Heart Association. Circulation2010;122(17):1756-76.
5. 5. Van de Werf F, Bax J, Betriu A, Blomstrom-Lundqvist C, Crea F, FalkVet al. ESC guidelines on management of acute myocardial infarction in patients presenting with persistent ST-segment elevation. RevEspCardiol 2009;62(3):293.
6. 6. Pope JH, Aufderheide TP, Ruthazer R, Woolard RH, Feldman JA, Beshansky JR, et al. Missed diagnoses of acute cardiac ischemia in the emergency department. N Engl J Med2000;342(3):1163-70.
7. 7. Diercks DB, Peacock WF, Hiestand BC, Chen AY, Pollack CV, Kirk JD,et al. Frequency and consequences of recording an electrocardiogram> 10 minutes after arrival in an emergency room in non–ST-segment elevation acute coronary syndromes (from the CRUSADE Initiative). Am J Cardiol2006;97(4):437-42.
8. 8 . To p o l EJ, e d it o r. To p o l'sTe x t b o o k o f CardiovascularMedicine. 6th ed. Philadelphia: Lippincott Williams &Wilkins, 2002: 391-410.

9. 9.Wittels K. Aortic emergencies. Emerg Med Clin North Am 2011;29(4):789-800.
10. 10. Omar HR, Mangar D, Khetarpal S, Shapiro DH, Kolla J, Rashad R, et al. Anteroposterior chest radiograph vs. chest CT scan in early detection of pneumothorax in traumapatients. IntArchMed2011;4(1):30.
11. 11. Aytekin S, Aytekin V, Güzelsoy D, Öztürk M, Demiroğlu C. Koroner Arterleri Normal Olan Hastalarda AnginaPektoris Nedenleri Üstüne Bir Araştırma. GKD Cer.Derg1992;1(1):177-80.
12. 12. Yavaşoğlu İ, KadıköylüG, Köseoğlu K, Bolaman Z.Yaşlı hastada kronik mezenterik iskeminin stentle başarılı tedavisi. Turkish Journal of Geriatrics2007;10(4):197-9.
13. 13. Silber SH, Leo PJ, Katapadi M. Serial electrocardiograms for chest pain patients with initial non diagnostic electrocardiograms: Implications for thrombolytict herapy. Acad Emerg Med.1996;3(2):147-52.
14. 14. Westbrook JL. Oesophageal achalasia causing respiratory obstruction. Anaesthesia.1992;47(1):38-40.