PREHOSPITAL DETECTION OF AN ACUTE MYOCARDIAL INFARCTION WITH ST SEGMENT ELEVATIONIN A COVID-19 POSITIVE PATIENT
Ključne reči:
pandemija, COVID 19, STEMI, diferencijalna dijagnoza, lična zaštita
Sažetak
Cilj I tokom pandemije COVID 19, bolesnici mogu razviti simptome STEMI. Prikazujemo COVID 19 pozitivnog pacijenta sa prehospitalnim STEMI, diferencijalno dijagnostičkim nedoumicama tokom hospitalizacije i primeni strategije visokog nivoa bezbednosti zdravstvenih radnika tokom zbrinjavanja.Prikaz bolesnika Ekipa HMP je transportovala bolesnika zbog sumnje na STEMI iz ambulante DZ u salu za kateterizaciju. Bolesnik je pregledan zbog anginoznog bola u sredogruđu. Epidemiološka ankete na COVID-19 negativna. Pri pregledu: GKS 15, subfebrilan, normotenzivan, normokardan, eupnoičan, SaO2 98%. Na EKG STEMI lateralne lokalizacije. Plasirana iv linija, ordinirana dvojna antiagregaciona terapija. Rapid testom je corona pozitivan. Transportovan direktno u salu za kateterizaciju covid bolnice. Uz STEMI, razmatrane su i druge diferencijalno-dijagnostičke dijagnoze. Kao definitivna, postavljena je dijagnoza Angina pectoris, non specificata. Zdravstveni radnici su na svim nivoima koristili ličnu zaštitnu opremu. Zaključak Ponekad prehospitalni STEMI nije i definitivnu dijagnozu. Preporučuje se strategija visokog nivoa bezbednosti zdravstvenih radnika.
Reference
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4. Tam CF, Cheung KS, Lam S, Wong A, Yung A, Sze M. Et al. Impact of Coronavirus Disease 2019 (COVID-19) Outbreak on ST-Segment–Elevation Myocardial Infarction Care in Hong Kong, China. Circ Cardiovasc Qual Outcomes. 2020; 13:e006631. DOI: 0.1161/CIRCOUTCOMES.120.006631.
5. 2020 ESC Guidance for the Diagnosis and Management of CV Disease in the Context of the COVID-19 Pandemic. Available: https://www.escardio.org/Education/COVID-19-and-Cardiology/ESC-COVID-19-Guidance.
6. Kovačević M, Srdanović I, Jung R. Šta nam novo donose preporuke za STEMI 2017?. Srce i krvni sudovi. 2017; 36(4): 225-228.
7. Mahmud E, Dauerman H, Welt FG, Messenger JC, Rao SV, Grines C, et al. Management of Acute Myocardial Infarction During the COVID-19 Pandemic. J Am Coll Cardiol. 2020; S0735-1097(20)35026-9. doi: 10.1016/j.jacc.2020.04.039. PMID: 32311816.
8. World Health Organization. Global surveillance for COVID-19 caused by human infection with COVID-19 virus: interim guidance, 20 March 2020. (2020; date last accessed). https://extranet.who.int/iris/restricted/handle/10665/331506
9. Center for Disease Control and Prevention. Coronavirus (COVID-19). https://www.cdc.gov/coronavirus/2019-nCoV/index.html.
10. European Centre for Disease Prevention and Control. ECDC technical report- Infection prevention and control for COVID-19 in healthcare settings - first update 12 March 2020 (March 12, 2020; date last accessed). https://www.ecdc.europa.eu/sites/default/files/documents/COVID-19-infection-prevention-and-control-healthcare-settings-march-2020.pdf.
11. Cheng X. Protecting cardiologists during the COVID-19 epidemic – lessons from Wuhan, China. (March 26, 2020; date last accessed). https://www.escardio.org/Education/COVID-19-and-Cardiology/protecting-cardiologists-during-the-covid-19-epidemic-lessons-from-wuhan.
12. Stručno-metodološko uputstvo za kontrolu unošenja i sprečavanje širenja novog korona virusa SARS-CoV-2 u Republici Srbiji. Beograd: Institut za javno zdravlje „Dr Мilan Јovanović Batut”, 2020.
13. Cepheid Receives Emergency Use Authorization from FDA for Rapid SARS-CoV-2 Test [news release]. Cepheid’s website. http://cepheid.mediaroom.com/2020-03-21-Cepheid-Receives-Emergency-Use-Authorization-from-FDA-for-Rapid-SARS-CoV-2-Test. Accessed March 21, 2020.
14. Ibanez B, James S, Agewall S, Antunes MJ, Bucciarelli-Ducci C, Bueno H, et al. 2017 ESC Guidelines for the Management of Acute Myocardial Infarction in Patients Presenting With ST-Segment Elevation: The Task Force for the Management of Acute Myocardial Infarction in Patients Presenting With ST-Segment Elevation of the European Society of Cardiology (ESC). Eur Heart J 2017. DOI: 10.1093/eurheartj/ehx393. PMID: 28886621.
15. Emiš-Vandlik A, Anđelić S, čolaković G, Bogunović S. Infarkt miokarda bez opstrukcije koronarnih arterija (MINOCA). Naučni časopis urgentne medicine HALO 194. 2019; 25(3): 165-172. doi: 10.5937/Halo1903165E.
16. Emiš-Vandlik N, Stefanović I, Anđelić S, Bogunović S, Nikolić T. Plućna embolija. Naučni časopis urgentne medicine HALO 194, 2013; 19(2): 65-77.
Objavljeno
2020/08/28
Rubrika
Prikaz bolesnika
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