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Medicina Interna

Print version ISSN 0872-671X

Abstract

LIMA, Joana C F et al. Fast-Track Management of Acute Chest Pain: Experience Gained in a Hospital from Alentejo. Medicina Interna [online]. 2021, vol.28, n.3, pp.3-8.  Epub Dec 01, 2021. ISSN 0872-671X.  https://doi.org/10.24950/o/235/20/3/2021.

Introduction:

As an effort to reduce mortality associated with acute myocardial infraction (AMI), a fast-track approach named Via Verde Coronária (VVC) was implemented nationwi-de in 2007. Data on how this approach is performing in different hospitals is still scarce. Our aims were to characterize the main diagnoses of patients included in VVC and to evaluate the proportion of cases diagnosed with AMI.

Material and Methods:

A retrospective observational study was undertaken in the emergency department of a hospital from Alentejo (06/2017-05/2018). Patients were included if they were aged 18 or older and presented AMI-related symptoms. The main diagnosis was retrieved from medical records and the proportion of AMI was calculated. Data analysis was performed using uni and bivariate statistics (IBM SPSS v.27.0).

Results:

A total of 338 patients were included, where 56.5% (n = 191) were male with a mean age of 63.9 ± 15.1 {19;96} years old. The majority of diagnoses were from the circulatory system (61.2%, n = 207). AMI was present in 27.2% (n = 92/338) of the sample. There were differences when comparing the number of risk factors between patients with AMI and non-AMI (2.83 ± 1.54 vs 2.06 ± 1.49 risk factors/patient, respectively; p < 0.001) and in patients with NSTEMI and STEMI (3.25 ± 1.36 vs 1.81 ± 1.50 risk factors/patient, respectively; p < 0.001). There was a statistically significant difference when analyzing the duration of pain between patients with AMI and non-AMI (6.24 ± 9.08 vs 10.53 ± 18.23 hours of pain, respectively; p = 0.032).

Conclusion:

Data suggest that the majority of diagnosis in VVC was related to the circulatory system, and a quarter of them were AMI.

Keywords : Cardiovascular Diseases; Chest Pain; Critical Pathways; Emergency Service, Hospital; Myocardial Infarction.

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