2011, Number 3
V4R lead in diagnosis and management of acute coronary syndrome in the pre-hospital care
Language: Spanish
References: 13
Page: 2210-2216
PDF size: 145.54 Kb.
ABSTRACT
Introduction: The electrocardiogram is a simple and cheap complementary procedure t hat could be exploitable at maximum without delays or cost increase in diagnosis and management of the acute coronary syndrome (ACS). The use of V4R lead is recommended is there is suspicion of right ventricle infarction.Objective: T o describe the frequency in the use and diagnostic value of V4R lead in the lower face infarction during the pre-hospital care.
Method: A descriptive and retrospective study was conducted in 96 patients diagnosed with ACS with a rise of ST in the lower face during the first semester of 2010. The variables used were: age, sex, and personal pathological history, clinical and evolutionary picture at admission, pharmacologic management and achievement of V4R lead.
Results: From the 96 patients the 55,2 % were males, the mean age was of 56 years with predominance of high blood pressure as pathological background in a 39,5 % of the sample; the oppressive pain, hypotension and bradycardia were the commonest manifestations at admission. In the cases who received sublingual nitroglycerine there was posterior hypotension in a 33,3 % of patients. In all the cases a 12 leads- electrocardiogram was performed and only in a 12,5 % (P ‹ 0,0001) V4R lead was carried out. From them, 11 (P = 0,0094) had a rise of ST in that lead.
Conclusion: The use of electrocardiogram, specifically of right leads is useful to diagnose the right ventricle infarction, used of a insufficient way in patients presenting with lower face infarction during pre-hospital care.
REFERENCES
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O’Connor RE et al. Part 10: acute coronary syndromes: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2010;122(suppl 3):S787–S817.Revisado online 20 de diciembre. Disponible en: http://circ.ahajournals.org/cgi/content/full/122/18_suppl_3/S787