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FACP. Colegio de médicos de Tarragona Nº 4305520 / fgcapriles@gmail.com




Thursday, March 12, 2015

Anomalías regionales de contractilidad (RWMAs)

by Point-of-Care Echocardiography
ACEP Now - Februray 11, 2015 - By Johnson B, Lovallo E, Frenkel O Nagdev A
"More than 6 million emergency department visits a year in the United States are for chest pain.1 While there are approximately 1.1 million hospitalizations a year for acute coronary syndrome (ACS) in the United States, only approximately 30 percent of cases are ST-elevation myocardial infarctions. The remaining 70 percent are diagnosed with unstable angina (UA) or non–ST-elevation myocardial infarction (NSTEMI). Risk stratification of chest pain patients with concern for ACS is of high concern in the emergency department. The American Heart Association (AHA) current guidelines recommend prompt management and possibly invasive strategies for patients with UA and NSTEMI who present with high-risk features. Often in the ED setting, chest pain patients have a nondiagnostic electrocardiogram (ECG), and initial cardiac biomarkers can be negative even with significant coronary artery occlusion...
Investigation of regional wall motion abnormalities (RWMAs) is a Class I recommendation by the AHA in the hands of trained echocardiogram technicians. The goal is to identify patients with RWMAs likely representing a significant occult coronary artery thrombosis not evident by symptoms, ECG, or initial cardiac biomarkers that could then benefit from an invasive intervention."