tailieunhanh - Báo cáo y học: " Myocardial infarction on the ICU: can we do better"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Myocardial infarction on the ICU: can we do better? | Available online http content 12 2 129 Commentary Myocardial infarction on the ICU can we do better Ian Webb and James Coutts Department of Cardiology St Thomas Hospital Guys and St Thomas NHS Foundation Trust London SE1 7EH UK Corresponding author James Coutts Published 3 April 2008 This article is online at http content 12 2 129 2008 BioMed Central Ltd Critical Care 2008 12 129 doi cc6832 See related research by Lim et al. http content 12 2 R36 Abstract Myocardial infarction remains a major cause of death despite contemporary therapeutic strategies. Diagnosis in the intensive care unit is challenging but is essential to target therapy accurately. In this issue of Critical Care Lim and colleagues present the results of a prospective non-interventional screening study for acute myocardial infarction in patients admitted to the intensive care unit. Myocardial infarction is observed to occur frequently often without being clinically apparent with a high associated mortality. Such approaches may facilitate accurate diagnosis of myocardial infarction in this setting hence opening the way to improved therapy. Myocardial infarction MI in the critically ill presents a diagnostic challenge to the physician and is associated with a particularly adverse outcome for the patient 1 . Such patients have high metabolic demands and are often subject to sustained adverse physiology. Typical signs and symptoms can be difficult to elicit and surrogate physiological markers of impaired coronary perfusion masked or misinterpreted in the context of the index pathology. Cardiac troponin measurements and the 12-lead echocardiogram ECG remain sensitive in this setting but specificity decreases resulting in diagnostic uncertainty. Recent consensus guidelines from the European Society of Cardiology American College of Cardiology Foundation American Heart Association and World Heart Federation emphasise the role of cardiac .

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