Acute coronary syndrome with persistent ST- segment elevation

Abstract

Introduction: After WHO dates annually, 2.5 million people are hospitalized in Department of Medical Emergency with diagnosis: Acute Coronary Syndrome (ACS). Annual incidence of morbidity in ACS constitutes 3 per 1000 inhabitants, mortality 3-5% (ESC 2011). According to the National Statistics Committee of US dates, 1 million patients are hospitalized with ACS every year in USA, while in Europe (France, Italy, and Germany) the number is over 750000. In 2014 the total number of requests to the Department of Medical Emergency about cardiovascular emergencies in Chisinau, constituted 21, 4%, where 23, 7% are major emergency requests. The frequency of ACS in major cardiovascular emergencies is 31, 2%, where 12, 4% are reserved for ACS with persistent elevation of segment ST. Methods and materials: Study group enrolled 102 patients who addressed in Department of Medical Emergency in Chisinau in 2014 with diagnosis ACS with persistent elevation of segment ST has been investigated. The analysis of incidence and frequency of queries’ people to the DME service was done and the structure of cardiovascular emergency; social analysis (age, sex, social state); analysis of the protocol of management and it’s conformity to current standards; analysis of the prehospital complications. Patient’s management with ACS with persistent elevation of segment ST was based on the recommendations of the Society of Cardiologists and clinical protocol of IMA 2014.Discussion results:After the taken studies, it was found that 55367 requests have been done during 2014 in Chisinau, where 13101 are major emergency requests. From all of the cases of major emergencies 4078 (31, 2%) were with ACS requests, where 506 (12, 4%) cases with ACS with persistent elevation of segment ST. The mean age of patients as 65 years old. In our study 55 patients (53, 92%) had a cardiovascular history, where 55 cases the most common disease is hypertension. The execution of management protocol is carried out not in full volume and prehospital complications are about 36 cases (35, 29%), where 17 cases – cardiogenic shock, 9 cases – pulmonary edema, 10 cases – cardiac arrhythmias. Conclusion 1. The incidence of ACS with persistent elevation of segment ST in structure of population access to the service AMU and in structure of cardiovascular emergencies increases and needs immediate treatment, according to international guidelines and national clinical protocols for management of ACS in the prehospital phase. 2. ACS with persistent elevation of segment ST is encountered in all social groups and different sex since age 40: males of 60-69 years and women of 70-79 years. 3. The study shows that in reason of prehospital complication the first place goes to cardiogenic shock; II - cardiac arrhythmias; III - pulmonary edema. Severe complications were recorded in the groups where a treatment protocol has been partial violated or non-aproved drugs have been prescribed.