Göğüs Ağrısı
Özet
Göğüs ağrısı, basit kas rahatsızlıklarından akut koroner sendrom gibi yaşamı tehdit eden durumlara kadar uzanan geniş bir etiyolojik yelpazeye sahip kritik bir semptomdur. Tanı sürecinde hastanın hayati tehlikesinin belirlenmesi öncelikli hedef olup; anamnez, fizik muayene ve EKG gibi yöntemlerle kardiyak ve kardiyak olmayan nedenlerin ayırıcı tanısı yapılır. Özellikle ST segment yükselmeli miyokard infarktüsü gibi durumlarda, mortaliteyi azaltmak için hızlı tanı ve acil revaskülarizasyon müdahalesi büyük önem taşımaktadır.
Chest pain is a critical symptom with a broad etiological spectrum ranging from simple muscle disorders to life-threatening conditions such as acute coronary syndrome. The primary goal in the diagnostic process is to determine if the patient's life is at risk, using anamnesis, physical examination, and ECG to differentiate between cardiac and non-cardiac causes. Rapid diagnosis and emergency revascularization are vital, particularly in cases like ST-segment elevation myocardial infarction, to reduce mortality and morbidity
Referanslar
Yeter E, Akçay M, Yüksel İÖ. Göğüs ağrılı hastaya tanısal yaklaşım. Turkish Medical Journal. 2008;2:54-59.
Twerenbold R, Badertscher P, Boeddinghaus J, et al. 0/1-hour triage algorithm for myocardial infarction in patients with renal dysfunction. Circulation. 2018;137:436-451.
Boeddinghaus J, Nestelberger T, Twerenbold R, et al. Impact of age on the performance of the ESC 0/1halgorithms for early diagnosis of myocardial infarction. Eur Heart J. 2018;39:3780-3794.
Boeddinghaus J, Twerenbold R, Nestelberger T, et al. Clinical validation of a novel high-sensitivity cardiac troponin i assay for early diagnosis of acute myocardial infarction. Clin Chem. 2018;64:1347-1360.
Twerenbold R, Neumann JT, Sorensen NA, et al. Prospective validation of the 0/1-h algorithm for early diagnosis of myocardial infarction. J Am Coll Cardiol. 2018;72:620-632.
Boeddinghaus J, Reichlin T, Cullen L, et al. Two-hour algorithm for triage toward rule-out and rule-in of acute myocardial infarction by use of high-sensitivity cardiac troponin I. Clin Chem. 2016;62:494-504.
Azmy C, Guerard S, Bonnet X, et al. EOS orthopaedic imaging system to study patellofemoral kinematics: assessment of uncertainty. Orthop Traumatol Surg Res 2010;96:28-36.
Hillinger P, Twerenbold R, Wildi K, et al. Gender-specific uncertainties in the diagnosis of acute coronary syndrome. Clin Res Cardiol. 2017;106:28-37.
Miller-Hodges E, Anand A, Shah ASV, et al. High-sensitivity cardiac troponin and the risk stratification of patients with renal impairment presenting with suspected acute coronary syndrome. Circulation 2018;137:425-435.
Rubini Gimenez M, Badertscher P, Twerenbold R, et al. Impact of the US food and drug administration-approved sex-specific cutoff values for highsensitivity cardiac troponin T to diagnose myocardial infarction. Circulation 2018;137:1867-1869.
Rubini Gimenez M, Twerenbold R, Boeddinghaus J, et al. Clinical effect of sex-specific cutoff values of high-sensitivity cardiac troponin T in suspected myocardial infarction. JAMA Cardiol. 2016;1:912-920.
Mueller-Hennessen M, Lindahl B, Giannitsis E, et al. Diagnostic and prognostic implications using age- and gender-specific cut-offs for high-sensitivity cardiac troponin T - sub-analysis from the TRAPID-AMI study. Int J Cardiol. 2016;209:26-33.
Sorensen NA, Neumann JT, Ojeda F, et al. Relations of sex to diagnosis and outcomes in acute coronary syndrome. J Am Heart Assoc. 2018;7:007297.
Lindsell CJ, Anantharaman V, Diercks D, et al. The Internet Tracking Registry of Acute Coronary Syndromes (i*trACS): A multicenter registry of patients with suspicion of acute coronary syndromes reported using the standardized reporting guidelines for emergency department chest pain studies. Ann Emerg Med. 2006;48:666-677.
Launbjerg J, Fruergaard P, Hesse B, et sal. Long-term risk of death, cardiac events and recurrent chest pain in patients with acute chest pain of different origin. Cardiology. 1996;87:60-66.
Amsterdam EA, Wenger NK, Brindis RG, et al. 2014 AHA/ACC guideline for the management of patients with non-ST-elevation acute coronary syndromes: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2014;64(24):139-228.
Gulati M, Levy PD, Mukherjee D, et al. 2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR Guideline for the Evaluation and Diagnosis of Chest Pain: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2021;30;144(22):368-454.
Hsia RY, Hale Z, Tabas JA. A national study of the prevalence of life-threatening diagnoses in patients with chest pain. JAMA Intern Med. 2016;176:1029–1032.
Fanaroff AC, Rymer JA, Goldstein SA, et al. Does this patient with chest pain have acute coronary syndrome?:the rational clinical examination systematic review. JAMA. 2015;314:1955–1965.
Diercks DB, Boghos E, Guzman H, et al. Changes in the numeric descriptive scale for pain after sublingual nitroglycerin do not predict cardiac etiology of chest pain. Ann Emerg Med 2005;45:581–585.
McConaghy JR, Oza RS. Outpatient diagnosis of acute chest pain in adults. Am Fam Physician. 2013;87: 177–182.
Diercks DB, Kontos MC, Chen AY, et al. Utilization and impact of pre-hospital electrocardiograms for patients with acute ST-segment elevation myocardial infarction: data from the NCDR (National Cardiovascular Data Registry) ACTION (Acute Coronary Treatment and Intervention Outcomes Network) Registry. J Am Coll Cardiol. 2009;53:161–166.
Puymirat E, Simon T, Steg PG, et al. Association of changes in clinical characteristics and management with improvement in survival among patients with STelevation myocardial infarction. JAMA. 2012;308:998– 1006.
Jollis JG, Granger CB, Henry TD, et al. Systems of care for ST-segment-elevation myocardial infarction: a report from the American Heart Association’s Mission: Lifeline. Circ Cardiovasc Qual Outcomes. 2012;5:423– 428.
O’Gara PT, Kushner FG, Ascheim DD, et al. 2013 ACCF/AHA guideline for the management of STelevation myocardial infarction: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2013;61:78–140.
Becker L, Larsen MP, Eisenberg MS. Incidence of cardiac arrest during self-transport for chest pain. Ann Emerg Med. 1996;28:612–616.
Jain S, Ting HT, Bell M, et al. Utility of left bundle branch block as a diagnostic criterion for acute myocardial infarction. Am J Cardiol. 2011;107:1111– 1116.
Roffi M, Patrono C, Collet JP, et al. 2015 ESC guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: Task Force for the Management of Acute Coronary Syndromes in Patients Presenting Without Persistent ST-Segment Elevation of the European Society of Cardiology (ESC). Eur Heart J. 2016;37:267–315.
Collet JP, Thiele H, Barbato E, et al. 2020 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation. Eur Heart J. 2021 Apr 7;42(14):1289-1367.
