[Emergency catheterization in a coronary intensive care unit. The diagnostic and therapeutic implications].

OBJECTIVE

to evaluate the diagnostic and therapeutic role of emergency hemodynamic studies, in the coronary intensive care (UCI).

STUDY DESIGN

Retrospective study of--patients (P) submitted to emergency catheterization.

PATIENTS

183 P (152 M and 31 F), mean age 56 +/- 11.5 years, admitted to UCI of Hospital Santa Marta and who had cardiac catheterization performed, between October 88 and November 92.

METHODS

Patient clinical files were reviewed. We considered the reasons for emergency cardiac catheterization; final diagnosis; complications in the first 24 hours; catheterization role in the therapeutic orientation.

RESULTS

Reasons for hemodynamic study were: coronary artery disease (CAD) in 127 P (69%); aortic dissection in 33 P (18%); valvular disease in 19 P (10%) and other in 4 P (3%). Clinical diagnosis was confirmed in 92% and changed in 8% by hemodynamic study results. Left main coronary artery disease was diagnosed in 6.5% of CAD patients. Coronary artery disease was excluded in 5 P with previous CAD diagnosis, in 19 P with aortic dissection and in 11 valvular patients. 32% of P were sent to emergent surgery: 93% ascending aortic dissection and 20% of CAD, 76% of valvular disease. The hemodynamic study was decisive in the therapeutic option of myocardial revascularization in 77% of P with CAD: 39 emergent PTCA (31%), 13 primary (33%) and 14 P oriented to elective PTCA (11%); 26 emergent surgery and 19 P oriented to elective surgery (15%). The emergency cardiac catheterization mortality rate was 0.5%, and the morbidity 2.7%.

CONCLUSIONS

The contribution of Hemodynamic Department to UCI was decisive in the diagnostic and therapeutic orientation of critical patients.