Selda Özel COŞKUN, Vermi DEĞERLİ, Gökhan ELÇİN, Burcu DENİZLİOĞLU, Erman YILDIRIM, Neslihan SİLİV, Ali Savaş MİRAN, İsmet PARLAK

ACİL SERVİSE GÖĞÜS AĞRISI İLE BAŞVURAN HASTALARIN AKUT KORONER SENDROM ORANLARININ DEĞERLENDİRİLMESİ

Göğüs ağrısı GA şikâyeti, acil servislere AS başvuruların en sık nedenlerinden birisidir. Göğüs ağrısı şikayeti ile başvuran olgularda erken müdahale edilmeyi gerektiren akut koroner sendrom AKS tanısını koymak her zaman mümkün olmayabilir. Bazı hasta grubunda tanıya gidilmesi için hastaların klinik veya Elektokardiyografik EKG olarak izlemi gerekmektedir. Çalışmamızın amacı; Acil Servise tipik yada atipik Göğüs Ağrısı şikâyetiyle başvuran ve iskemik göğüs ağrısı olduğu düşünülen hastaların AKS oranlarının değerlendirilmesidir. AS’e, GA şikâyeti ile başvuran onsekiz yaş üstü ve nontravmatik tüm hastalar çalışmaya alındı. Çalışmaya dahil olmama kriterlerine ise;Travma hastaları,18 yaş altı hastalar, GA tariflemeyen hastalar, ST elavasyon myokart infarktüsü STEMI olan hastalar, kendi isteğiyle çalşmadan ayrılan hastalar, çalışmaya katılmayı kabul etmeyen hastalar, izleminde veri toplama formunda eksiklik olan hastalardan oluşmaktadır. Hastaların Çalışmaya 411 hasta alındı. Çalışmaya alınan hastaların 240’ı erkek %58,4 , 171’i %41,6 kadındı. Hastaların 314’ü %76,4 65 yaş ve altı iken, 97’si %23,6 65 yaş üstünde bulundu. Çalışmaya alınan hastaların 266’ında %73,3 KAH için en az bir risk faktörü varken, 71 hastada %26,7 birden fazla risk faktörü bulundu. Atipik semptomlarla başvuran hastalarda Akut Koroner Sendrom oranı %6,9 olarak saptandı. AKS’lu hastaların ilk geliş EKG’leri %53,9’u normal iken takip EKG'lerinde %16,9’unun EKG’sinde değişiklik saptandı. Tipik göğüs ağrısı olanlardaki AKS varlığı ve EKG değişikliği oranları atipik göğüs ağrısı olanlardaki AKS varlığı ve EKG değişikliği oranlarından yüksek olarak gözlendi p

Anahtar Kelimeler:

akut koroner sendrom, EKG, troponin, anjina pektoris, acil tıp

EVALUATING THE ACUTE CORONARY SYNDROME RATES OF THE PATIENTS WHO APPLY TO EMERGENCY SERVICE WITH CHEST PAIN

Chest Pain CP is one of the most frequent complaints observed in Emergency Services ES . It may not always be possible to diagnose the Acute Coronary Syndrome ACS , which requires immediate intervention in cases with CP. It is necessary that a clinical or Electrocardiographic ECG observation is performed in some patient groups to be able to diagnose the disease accurately. The purpose of this study is evaluating the ACS rates of the patients who apply to the Emergency Service with typical or atypical Chest Pain and who are considered to have ischemic chest pain. The patients who were non-traumatic and over 18 years of age who applied to the ES with CP complaints were included in the study. The criteria for not being included in the study were; being trauma patients, patients who were below the age of 18, patients whose APs were not defined; patients with ST Elevation Myocardia Infarct STEMI , patients who left the study with their own will, patients who did not want to participate in the study, and patients whose data collection forms had missing points in terms of observations. Doctor’s opinions on the complaints of the patients were determined as Typical Chest Pain or Atypical Chest Pain. The troponin and ECG follow-up of the patients were performed. The patients who were diagnosed according to the high troponin levels and ECG change were evaluated. The patients were examined in terms of gender, age, complaints for applying to the emergency service, background characteristics, TIMI risk factors, latest diagnoses, and the prognostic accuracy of the TIMI risk score. 411 patients were included in the study. 240 of the patients who participated in the study were male 58,4% , and 171 were female 41,6% . 314 of the patients 76,4% were at or below the age of 65, and 97 of them 23,6% were over the age of 65. 266 of the patients 73,3% had at least one risk factor for Coronary Artery Disease CAD , and 71 of them 26,7% had more than one risk factor. The Acute Coronary Syndrome ACS rate in the patients who applied with atypical symptoms was determined as 6,9%. The ECGs of the patients with ACS at the arrival were normal in 53,9%; however, changes were observed in the follow-up ECGs as 16,9%. The ACS existence and ECG change rates of the patients with Typical Chest Pain were observed as being higher than the ACS existence and ECG change rates of the patients with Atypical Chest Pain p

Keywords:

acute coronary syndrome, ECG, troponin, angina pectoris, emergency medicine,

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