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Artigo Acesso aberto Produção Nacional
BIBTEX RIS

Síndromes coronarianas agudas: tratamento e estratificação de risco

2008; Associação de Medicina Intensiva Brasileira; Volume: 20; Issue: 2 Linguagem: Inglês

10.1590/s0103-507x2008000200014

ISSN

1982-4335

Autores

Antônio Eduardo Pereira Pesaro, Paulo César Gobert Damasceno Campos, Marcelo Katz, Thiago Domingos Corrêa, Elias Knobel,

Tópico(s)

Cardiac Imaging and Diagnostics

Resumo

Acute coronary syndromes result from a disruption of a vulnerable coronary plaque complicated by intraluminal thrombus formation, embolisation, and variable degrees of coronary obstruction. Patients with total occlusion may present with acute ST Elevation Myocardial Infarction (STEMI). Partial vessel obstruction may result in Non-ST-Elevation Acute Myocardial Infarction (NSTEMI) or unstable angina (UA). Clinical symptoms and electrocardiographic changes are the main components of identification of ACS. The rapid and effective triage of such patients regarding presence or absence of ST-segment elevation is critical to dictate further therapeutic strategies. The objective of this chapter was to review current evidence and recommendations for the evaluation and early treatment of acute coronary syndromes.We performed a clinical review using the electronic databases MedLine and LILACS from January 1990 to September 2007.Reperfusion of the infarct-related artery is the cornerstone of therapy for STEMI. Fibrinolysis and percutaneous coronary intervention are both well established as effective options. Management of UA/NSTEMI patients requires early risk stratification. High-risk patients should undergo an early invasive strategy that consists in performance of cardiac catheterization in the first 24 to 48 hours of presentation.

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