Vol. 11. Núm. 87.
Páginas 5209-5213 (Octubre 2015)

Protocolos de práctica asistencial
Protocolo diagnóstico-terapéutico del síndrome coronario agudo sin elevación del segmento ST en Urgencias

Diagnostic and therapeutic protocol for acute coronary syndrome without ST-segment elevation in the Emergency Department

M. Juárez Fernández*I. Sousa CasasnovasF. Díez del Hoyo
Doi : https://10.1016/j.med.2015.09.014
Opciones
Resumen

Los síndromes coronarios agudos son la principal complicación de la cardiopatía isquémica. El síndrome coronario agudo con elevación del ST es más fácil de diagnosticar y de tratar, ya que requiere reperfusión inmediata; sin embargo, el síndrome coronario agudo sin elevación del ST plantea más dificultades diagnósticas y es más heterogéneo en cuanto a su causa, el pronóstico y el tratamiento. El diagnóstico se basa en la historia clínica, el ECG y la determinación de troponinas. Los pilares del tratamiento son la doble antiagregación y la anticoagulación, y en general, salvo en los pacientes de bajo riesgo, se recomienda una estrategia invasiva basada en la coronariografía.

Palabras clave
Síndrome coronario agudo sin elevación del ST
Riesgo isquémico
Tratamiento antitrombótico
Coronariografía
Abstract

Acute coronary syndromes are a major complication of coronary heart disease. Acute coronary syndrome with ST elevation is easier to diagnose and treat because it requires immediate reperfusion, however acute coronary syndrome without ST elevation raises more diagnostic difficulties and is more heterogeneous in their cause, prognosis and treatment. Diagnosis is based on clinical history, ECG and troponin determination. The mainstays of treatment are dual antiplatelet therapy and anticoagulation, and in general, except in low risk patients, an invasive strategy based on coronary angiography is recommended.

Keywords
Acute coronary syndrome without ST elevation
Ischemic risk
Antithrombotic therapy
Coronariography

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