Author/Editor		Pust, Borut; Kenda, Miran F
Title		Priporočila za odkrivanje in obravnavo nestabilne angine pektoris
Translated title		Recommendations for diagnosing and managing unstable angina pectoris
Type		članek
Source		Zdrav Vestn
Vol. and No.		Letnik 68, št. 4
Publication year		1999
Volume		str. 235-8
Language		slo
Abstract		Background. Unstable angina pectoris is besides Q-and non-Q myocardial infarction one of three acute coronary syndromes with very often unclear and unstable prognosis. The absence of ECG markers of myocardial ischemia during anginal attacks, clearly positive effects of antiischemic drugs on frequency and duration of anginal attacks and lack of left ventricular failure are considered as characteristic of favourable prognosis in respect to acute myocardial infarction and patients survival. Their presence obviously reduces or even excludes the need for urgent myocardial revascularisation, as pointed out by Braunwald's panel of experts - suported from the U.S. Department of Health and Human Sevices. This rationale approach - based on extensive literature reviews and consensus among members of expert panel can reduce the need for urgent invasive procedures in patients admitted for unstable angina for nearly 90% and hence substantially reduce the costs and increase the safety of patients in diagnosing and managing unstable angina.
Summary		Izhodišča. Nestabilna angina pektoris je poleg transmuralnega in netransmuralnega infarkta le eden od treh akutnih koronarnih sindromov z mnogokrat nejasno in lahko tudi hitro spremenljivo prognozo. Odsotnost znakov ishemije miokarda v EKG med napadi prsne bolečine, očitno pozitiven učinek protiishemičnih zdravil na pogostnost in trajanje pektanginoznih napadov in odsotnost znakov popuščanja levega prekata pomenijo dobro prognozo, kar zadeva možnost infarkta in preživetje bolnika in zmanjšujejo ali celo izključujejo potrebo po nujni revaskularizaciji miokarda, kot meni Braunwaldova skupina izvedencev v imenu Ministrstva z zdravstvo ZDA. Takšen raconalni pristop - temelječ na izčrpnem pregledu literature in soglasju izvedencev, lahko zmanjša potrebo po nujnih invazivnih posegih za skoraj 90% in seveda temu primerno tudi zmanjša materijalne stroške in celo poveča varnost bolnikov pri odkrivanju in zdravljenju nestabilne anginepektoris. Zaključki. V Sloveniji bi pri obravnavanju nestabilne angine pektoris kazalo slediti priporočilom Braunwaldove skupine izvedencev, saj nimamo lastnih pomembnih objavljenih rezultatov obravnavanja tega pogostnega akutnega koronarnega sindroma.
Descriptors		ANGINA, UNSTABLE PRACTICE GUIDELINES ELECTROCARDIOGRAPHY