EARLY LABORATORY INDICATORS OF ACUTE MYOCARDIAL INFARCTION - 09/09/11
Résumé |
Ischemic heart disease remains the leading cause of death in the United States. Coronary atherosclerosis results in 1.5 million heart attacks per year, with approximately 500,000 deaths. Effective intervention is predicated on timely diagnosis of acute myocardial infarction (AMI).27 , 74 The World Health Organization definition of AMI requires two of the following three criteria: 1) presence of characteristic chest pain for a period of time; 2) diagnostic electrocardiogram (ECG) changes; and 3) typical rise and fall of serum levels of cardiac markers.43 , 85 Approximately 5% of patients with AMI are released unintentionally from emergency departments (EDs), placing them at high risk for later morbidity and mortality.26 This is because up to one fourth of patients with AMI present with atypical signs and symptoms. Electrocardiography (ECG) remains the most specific diagnostic tool, but about 40% of patients have nondiagnostic ECG changes at the time of admission.23 These limitations make clinical recognition of AMI difficult, and approximately 60% to 70% of patients admitted to the hospital because of chest pain eventually are discharged with a different diagnosis.47 The use of biochemical markers remains a cornerstone in the diagnosis of acute coronary syndromes.
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Address reprint requests to Douglas M. Char, MD, Division of Emergency Medicine, Campus Mail Box #8072, Washington University School of Medicine, 660 South Euclid Avenue, St. Louis, MO 63110 |
Vol 16 - N° 3
P. 519-539 - août 1998 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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