ELETROCARDIOGRAMA PADRÃO DE 12 DERIVAÇÕES PARA DIAGNÓSTICO DA OCLUSÃO CORONARIANA AGUDA: NOVA ABORDAGEM ELETROCARDIOGRÁFICA DAS SÍNDROMES CORONARIANAS
DOI:
https://doi.org/10.25110/arqsaude.v27i3.2023-023Palavras-chave:
Síndrome Coronariana Aguda, Oclusão Coronariana, Infarto Agudo do Miocárdio, Eletrocardiograma, Revisão IntegrativaResumo
Introdução: As síndromes coronarianas agudas decorrem de ruptura de placa coronariana com formação de trombos, embolização e obstrução, dependendo do nível de obstrução, podemos ter infartos e anginas e a nível eletrocardiográfico podemos ter ou não o supra desnivelamento do segmento ST. Para o correto diagnóstico e melhor prognóstico é importante acompanhar suas manifestações clínicas e avaliar as alterações eletrocardiográficas. Objetivo: Estudar uso do eletrocardiograma padrão de 12 derivações, para diagnóstico da oclusão coronariana aguda: uma nova abordagem eletrocardiográfica das síndromes coronarianas. Método: Estudo de revisão integrativa, com dados secundários da Biblioteca Virtual em Saúde (BVS), base eletrônica de dados da Literatura Latino – Americana e do Caribe em Ciências da Saúde (Lilacs) e da biblioteca digital Scientific Electronic Library Online (Scielo). Resultados: Descreveu-se 7 achados eletrocardiográficos sugestivos de oclusão coronariana aguda: padrões como os De Winter, Wellens, IAM posterior, distorção final do QRS, Critérios de Sgarbossa-Smith para IAM associado a BRE ou ritmo de marca-passo ventricular, ondas T’s hiperagudas e fórmulas matemáticas para diagnóstico da oclusão da descendente anterior. Conclusão: Embora a abordagem que se vale de tais achados no ECG seja mais acurada na detecção da oclusão coronariana aguda do que os critérios milimétricos do segmento ST, essa nova abordagem precisa de mais estudos para avaliação de seu real poder diagnóstico.
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