Rev Esp Cardiol
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The main aim of this study was to demonstrate that a protocol for managing syncope in the emergency department that is based on the early detection of heart disease enables patients to be diagnosed quickly and with few admissions, without there being a negative impact on prognosis. ⋯ Implementation of a protocol for managing syncope in the emergency department that was based on screening patients according to the presence of heart disease enabled a large percentage to receive a diagnosis. Moreover, the majority of patients could be discharged rapidly from the emergency department without there being any negative impact on medium-term prognosis.
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To investigate out-of-hospital treatment, including fibrinolysis, in patients with ST-elevation acute myocardial infarction and to determine the 1-year survival rate. ⋯ In routine clinical practice, out-of-hospital fibrinolysis was performed safely, reduced short-term mortality, and improved the 1-year survival rate. The combination of appropriate out-of-hospital treatment, including early defibrillation and fibrinolysis within the first three hours, together with the systematic application of percutaneous coronary intervention during hospital admission is a suitable treatment strategy for the comprehensive care of patients with ST-elevation acute myocardial infarction.
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A new index for predicting embolic risk in nonvalvular atrial fibrillation has been proposed, the CHADS2 score, which is calculated by adding 1 point each for the presence of congestive heart failure, hypertension, age 75 years or older, and diabetes, and by adding 2 points for a history of stroke or transient ischemic attack (TIA). Our objective was to evaluate the use of this score in a Mediterranean population. ⋯ The CHADS2 score proved useful for quantifying the risk of an embolic event in Mediterranean patients with nonvalvular atrial fibrillation. In our series, the risk of embolism in patients with a low score was not negligible.