Author/Editor		Noč, Marko
Title		Zmote pri prepoznavanju in zdravljenju bolnikov z akutnimi koronarnimi sindromi
Translated title		Pitfalls in the recognition and treatment of patients with acute coronary syndromes
Type		članek
Source		In: Bručan A, Gričar M, editors. Urgentna medicina: izbrana poglavja 6. Zbornik 7. mednarodni simpozij o urgentni medicini; 2000 jun 14-17; Portorož. Ljubljana: Slovensko združenje za urgentno medicino,
Publication year		2000
Volume		str. 123-31
Language		slo
Abstract		Acute coronary syndromes are due to coronary thrombosis which evolves on a ruptured atherosclerotic plaque. The consequent myocardial ischemia may result in unstable angina pectoris or acute myocardial infarction. The common denominator of acute coronary syndromes is ischemic cardiac pain. Initial 12-lead electrocardiogram is crucial for further treatment of these patients. Patients with ST-elevation require immediate reperfusion therapy by thrombolysis or primary percutaneous transluminal coronary angioplasty. Patients without ST-elevation (ST depression and/or T wave abnormalities) are candidates for initial medical antithrombotic and antischemic therapy. Survival and quality of life of patients with acute coronary syndromes depends on a sequence of events which may be, alike in the setting of sudden cardiac death, presented as a "Chain of survival". The links of this chain are patient by himself, prehospital emergency team and emergency department/coronary unit/catheterization laboratory in the hospital. After hospital discharge, the patient and his primary physician are responsible for rehabilitation and secondary prevention. Our prospective study on the prehospital treatment of patients of acute myocardial infarction in 1998 in Ljubljana demonstrated that only 19% of patients received Aspirin, 23% nitroglycerin, 35% oxygen and 14% morphine before arrival to the emergency department. Our patients, eligible for acute reperfusion therapy arrived to coronary unit almost one hour later than similar patients in Finland. This delay is due to both, patient delay and delays related to the prehospital evaluation/treatment and transportation.
Descriptors		CORONARY THROMBOSIS MEDICAL ERRORS MYOCARDIAL INFARCTION ANGINA, UNSTABLE ELECTROCARDIOGRAPHY ASPIRIN MORPHINE ANGIOPLASTY, TRANSLUMINAL, PERCUTANEOUS CORONARY THROMBOLYTIC THERAPY TRANSPORTATION OF PATIENTS MEDICAL HISTORY TAKING TIME FACTORS EMERGENCY SERVICE, HOSPITAL EMERGENCY MEDICAL SERVICES SLOVENIA FINLAND