文章基本信息

标题：ACUTE CORNARY SYNDROME WITH ST ELEVATION (STEMI) - PREHOSPITAL TROMBOLITIC THERAPY
其他标题：AKUTNI KORONARNI SINDROM SA ST ELEVACIJOM (STEMI) – PREHOSPITALNA TROMBOLITIČKA TERAPIJA
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作者：Ranka Bulajić ; Ranka Bulajić ; Vuk Niković 等
期刊名称：Zbornik Radova Akademije Umetnosti
印刷版ISSN：2334-8666
电子版ISSN：2560-3108
出版年度：2014
卷号：14
期号：1
页码：71-77
语种：English
出版社：Akademija umetnosti Univerziteta u Novom Sadu
摘要：INTRODUCTION: Acute coronary syndrome(ACS) refers to any group of symptoms attributed to obstruction of the coronary arteries. The most common symptom prompting diagnosis of ACS is chest pain, often radiating of the left arm or angle of the jaw, pressure-like in character, and associated with nausea and sweating. Acute coronary syndrome usually occurs as a result of one of three problems: ST elevation myocardial infarction (30%), non ST elevation myocardialinfarction (25%) or unstable angina (38%).Metalyse is indicated for the thrombolytical treatment of suspected myocardial infarction with persistent ST elevation or recent left bundle branch block within 6 hours after the onset of acute myocardial infarction symptoms. The amount of salvageable heart tissue is inversely related to the duration of coronary artery occlusion, up to 6 hours after the first symptoms of acute myocardial infarction (AMI), when myocardial ischaemia becomes irreversible. CASE REPORT: This is a case report about a 55 years old man who had a myocardial infarction and was treated with tromboliytic therapy in the prehospital setting by the emergency service.The patient rode a bicycle in the morning for about 10 km. While riding he felt chest pain, filling shortness of breath. Passerby called Emergeny services at 6:24 am. In the emergency car ECG was done which showed a ST segment elevation from V1 to V6 . Arterial pressure was 160/90mmHg, hart frequency 70/min, SpO2 96%, GCS 15.In the car was administered therapy: Zofran 4mg, Aspirin 500 IV. Heparin 10.000 IJ, Vendal 10mg, and in 6:52Metalyse amp. 10.000 IJ/10ml : 6000/1KG 55kg. Ringerlactate 500 ml IV. When patient arrived in Emergency department, laboratory analisys and heartultrasonography weremade.Heart ultrasonography was showed akinesia of the septum and anterior heart wall size of left ventricul 3.19 cm.Within 120 minutes primary coronary angiography was made, which showed proximal LAD stenosis 70% - 90% TIMI III , a implatation STENT. CONCLUSION:Prehospital thrombolysis in acute coronary syndrome with ST-segment elevation is very important for patient survival and reduce complications after ACS.
其他摘要：Uvod: Akutni koronarni sindrom (AKS) odnosi se na bilo koju grupu simptoma koji su povezani sa opstrukcijom koronarnih arterija. Najčešći simptom koji upućuju na dijagnoza AKS je bol u grudima, koji se često širi u levu ruku ili ugao vilice, bol je u vidu
关键词：Chest pain;the importance of early diagnosis of acute coronary syndrome; prehospital thrombolysis
其他关键词：bol u grudima; značaj rane dijagnostike akutnog koronarnog sindroma; prehospitalna tromboliza