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Abstract(s)
Introdução: O Enfarte Agudo do Miocárdio é das situações clínicas com maior impacto em Portugal, como na maioria dos países desenvolvidos, quer pela prevalência, quer pela elevada taxa de mortalidade e morbilidade que lhe estão associadas. Ocorrendo a maioria das mortes nas primeiras horas do desenvolvimento do Enfarte Agudo do Miocárdio, o “tempo” surge como o factor determinante no sucesso do tratamento. Nesse sentido, foram definidas estratégias, visando a redução do tempo entre o início dos sinais e sintomas e o início do tratamento do Enfarte Agudo do Miocárdio, designadamente a Via Verde Coronária.
Objectivo: Analisar epidemiologicamente o Enfarte Agudo do Miocárdio e avaliar o funcionamento da Via Verde Coronária, numa região do interior centro norte do País, face ao preconizado na Rede de Referenciação de Cardiologia, e às recomendações internacionais.
Metodologia: Foram analisados, retrospectivamente, os processos clínicos de todos os doentes que deram entrada, nos anos de 2012 e de 2013, na Unidade de Cuidados Intensivos Coronários, do Centro Hospitalar Tondela-Viseu, E.P.E., com Enfarte Agudo do Miocárdio.
Resultados: Registou-se maior incidência no sexo masculino (71,3%), mais acentuada nos casos de enfarte agudo do miocárdio com supradesnivelamento do segmento ST (75,2%), com mediana de 62 anos nos homens e de 72 anos nas mulheres. Como factores de risco conhecidos surge a hipertensão arterial (54,9%), a dislipidémia (50,7%), o stress (30,1%), o tabagismo (28,9%), a diabetes (25,6%) e a obesidade (25,2%). A “apresentação típica” do Enfarte Agudo do Miocárdio ocorreu em 81% dos casos. O “Tempo de início dos sintomas e o primeiro contacto médico ” registou uma mediana de 210 minutos; o “Tempo entre o primeiro contacto médico e o diagnóstico de Enfarte Agudo do Miocárdio com supradesnivelamento do segmento ST” registou uma mediana de 8 minutos, o “Tempo porta-balão” com uma mediana de 60 minutos, e o “Tempo total de isquemia” registou uma mediana de 285 minutos.
Discussão: Foram identificadas três áreas merecedoras de reflexão, susceptíveis da necessidade de maior intervenção: na educação e promoção da saúde e na prevenção da doença, corrigindo factores de risco do enfarte agudo do miocárdio; na literacia em saúde, conhecer e valorizar os sinais de alerta, bem como os meios de urgência / emergência; e na melhor articulação em rede dos serviços de saúde, proporcionando aos cidadãos mais equidade na resposta às suas necessidades em saúde.
Introduction: The Acute Myocardial Infarction is one of the clinic situations with more impact in Portugal, like in most developed countries, either for its prevalence or for the high rate of mortality and morbidity associated with it. As most of the deaths occur within the first hours of the development of the Acute Myocardial Infarction, “time” becomes the determinant factor on the treatment’s success. Therefore, strategies were determined, aiming to reduce the time between the first signals and symptoms and the AMI treatment, designated Coronary Fast-track System. Objective: Analyze epidemiologically the AMI and evaluate the functioning of the Coronary Fast-track System, in an interior central north region the country, facing the preconized on the Cardiology Referential Network, and the international recommendations. Methods: Medical records were, retrospectively, analyzed from all the patients that entered the Coronary Intensive Care Unit, of Centro Hospitalar Tondela-Viseu, E.P.E., between 2012 and 2013, with AMI. Results: A higher incidence on the male sex (71.3%) was registered, more accentuated in cases of ST elevation myocardial infarction (75.2%), with a median of 62 years in men and 72 years in women. As known risk factors, there was hypertension (54.9%), dyslipidemia (50.7%), stress (30.1%), smoking (28.9%), diabetes (25.6%) and obesity (25.2%). The "typical presentation" of AMI occurred in 81% of cases. The "symptom onset and first medical contact time" registered a median of 210 minutes; the "first medical contact and the diagnosis of ST-segment elevation myocardial infarction time" registered a median of 8 minutes, the "door-to-balloon time" with a median of 60 minutes, and the "total time of ischemia" registered a median of 285 minutes. Discussion: Three areas worthy of reflection were identified, which are susceptible of a greater intervention: in education, health promotion and in disease prevention, correcting risk factors for AMI; in health literacy, to know and recognize the warning signs, as well as the urgency / emergency access means; and better networking of health services, providing citizens with more equity in response to their health needs.
Introduction: The Acute Myocardial Infarction is one of the clinic situations with more impact in Portugal, like in most developed countries, either for its prevalence or for the high rate of mortality and morbidity associated with it. As most of the deaths occur within the first hours of the development of the Acute Myocardial Infarction, “time” becomes the determinant factor on the treatment’s success. Therefore, strategies were determined, aiming to reduce the time between the first signals and symptoms and the AMI treatment, designated Coronary Fast-track System. Objective: Analyze epidemiologically the AMI and evaluate the functioning of the Coronary Fast-track System, in an interior central north region the country, facing the preconized on the Cardiology Referential Network, and the international recommendations. Methods: Medical records were, retrospectively, analyzed from all the patients that entered the Coronary Intensive Care Unit, of Centro Hospitalar Tondela-Viseu, E.P.E., between 2012 and 2013, with AMI. Results: A higher incidence on the male sex (71.3%) was registered, more accentuated in cases of ST elevation myocardial infarction (75.2%), with a median of 62 years in men and 72 years in women. As known risk factors, there was hypertension (54.9%), dyslipidemia (50.7%), stress (30.1%), smoking (28.9%), diabetes (25.6%) and obesity (25.2%). The "typical presentation" of AMI occurred in 81% of cases. The "symptom onset and first medical contact time" registered a median of 210 minutes; the "first medical contact and the diagnosis of ST-segment elevation myocardial infarction time" registered a median of 8 minutes, the "door-to-balloon time" with a median of 60 minutes, and the "total time of ischemia" registered a median of 285 minutes. Discussion: Three areas worthy of reflection were identified, which are susceptible of a greater intervention: in education, health promotion and in disease prevention, correcting risk factors for AMI; in health literacy, to know and recognize the warning signs, as well as the urgency / emergency access means; and better networking of health services, providing citizens with more equity in response to their health needs.
Description
Keywords
Enfarte Agudo do Miocárdio Via Verde Coronária.