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在急诊科使用即时超声心动图识别急性冠状动脉综合征高危患者。

Identification of high-risk patients with acute coronary syndrome using point-of-care echocardiography in the ED.

作者信息

Frenkel Oron, Riguzzi Christine, Nagdev Arun

机构信息

Department of Emergency Medicine, Alameda Health System-Highland General Hospital, Oakland, CA.

Department of Emergency Medicine, Alameda Health System-Highland General Hospital, Oakland, CA.

出版信息

Am J Emerg Med. 2014 Jun;32(6):670-2. doi: 10.1016/j.ajem.2014.03.003. Epub 2014 Mar 15.

Abstract

Stratifying risk of patients with acute coronary syndrome (ACS) in the emergency department (ED) remains a frequent challenge. When ST-elevation criteria are absent, current recommendations rely upon insensitive and time-intensive methods such as the electrocardiogram and cardiac enzyme testing. Here, we report on a series of cases, where emergency physicians used a simplified model for identifying regional wall motion abnormalities by point-of-care echocardiography in patients presenting with chest pain to the ED. With the use of a simplified model described herein, high-risk patients with ACS were identified rapidly in a cohort usually difficult to risk stratify.

摘要

在急诊科(ED)对急性冠状动脉综合征(ACS)患者进行风险分层仍然是一项常见的挑战。当不存在ST段抬高标准时,当前的建议依赖于如心电图和心肌酶检测等不敏感且耗时的方法。在此,我们报告一系列病例,其中急诊医生使用一种简化模型,通过床旁超声心动图来识别胸痛就诊于ED的患者的局部室壁运动异常。通过使用本文所述的简化模型,在一个通常难以进行风险分层的队列中迅速识别出了高危ACS患者。

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