摘要:

Every year 5 million Americans present to emergency departments with chest pain; of these, 0.5 million will have myocardial infarction. The rapid and correct diagnosis of patients with chest pain is an extremely important aspect of emergency care. The article reviews the diagnostic and therapeutic aspects of chest pain evaluation in the emergency department.

ISSN:0164-2340    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

The troponin and myoglobin cardiac markers have emerged as useful tools in the cost-effective triage of patients presenting with chest pain. Levels of the cardiac-specific troponins I and T correlate with acute myocardial infarction and unstable angina prognoses, and myoglobin rises within 2 to 3 hours after the onset of chest pain in acute myocardial infarction. The use of these new markers in combination with creatinine kinase-MB provides improved risk stratification of patients presenting with chest pain.

ISSN:0164-2340    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

The prehospital electrocardiogram (ECG) is an underutilized but potentially beneficial technology now readily available in many regions. Field ECGs have been used to shorten the time to in-hospital reperfusion as well as to institute prehospital thrombolysis. Scene time does not appear to be significantly affected when a prehospital ECG is obtained. The most common limitation of this technology appears to be associated with cellular transmission. Future possibilities include smaller, more user-friendly units that still provide accurate ECGs. The article reviews the current literature to evaluate efficacy, accuracy, timeliness, and reliability of the prehospital ECG.

ISSN:0164-2340    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

Acute transmural myocardial infarction occurs secondary to thrombosis of a coronary artery. Prompt reperfusion is essential to salvage myocardium and preserve ventricular function. Thrombolytic therapy is successful in achieving complete reperfusion in only 60% of cases, and delays in therapy limit complete salvage in most patients. The article reviews the pathophysiology and treatment of acute myocardial infarction as well as future directions in care of this disease.

ISSN:0164-2340    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

Thrombolytic therapy and primary percutaneous transluminal coronary angioplasty (PTCA) are effective treatments for acute myocardial infarction, but which is better? Thrombolysis is more universally available, is less dependent on specialized facilities and expert personnel, and can be initiated earlier than primary PTCA. Conversely, primary PTCA provides higher infarct-related artery patency rates, better flow, earlier reperfusion times, lower risk of stroke, decreased risk of reinfarction, and lower mortality than thrombolytic therapy. Deciding between the two procedures requires careful consideration of the characteristics of the individual patient and the expertise available at the institution to perform primary PTCA.

ISSN:0164-2340    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

Congestive heart failure (CHF) is rapidly increasing in incidence and prevalence as the population ages. Because the elderly represent about 15% of all emergency department visits, and because CHF is the most common diagnosis in this population, emergency physicians will increasingly be called upon to diagnose this disease and order tests, initiate treatment, and make follow-up referrals for these patients. CHF is easy to recognize clinically, but its etiology and severity, key elements in selecting proper therapy, are difficult to assess. The article describes testing and appropriate therapy for CHF, which, if unrecognized or undertreated, severely affects life by shortening its length and reducing its quality.

ISSN:0164-2340    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

Cardiac arrhythmias are a major cause for emergency department evaluation in the United States each year. The article discusses the evaluation and management of the common supraventricular and ventricular arrhythmias encountered in emergency practice. The approach to bradydysrhythmias is also reviewed.

ISSN:0164-2340    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

Aortic dissection is a life-threatening medical emergency. Misdiagnosis can lead to catastrophic results. The article reviews the etiology, diagnosis, and treatment of aortic dissection.

ISSN:0164-2340    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

Pericardial tamponade is a medical emergency that requires a high index of suspicion, prompt diagnosis, and immediate treatment by pericardiocentesis. The diagnostic procedure of choice in suspected tamponade is echocardiography. The article reviews the etiology, pathophysiology, diagnosis, and treatment of this life-threatening condition.

ISSN:0164-2340    

出版商:OVID    

年代:1998

数据来源: OVID

ISSN:0164-2340    

出版商:OVID    

年代:1998

数据来源: OVID