Indicações de cinecoronariografia na doença arterial coronária

Abstract

Recent advances in Medical Science and the thechnological improvements in the field of myocardial revascularisation, in surgical procedures and in percutaneous interventions, made attractive the initial option for invasive strategies in the management of coronary heart disease. For this reason, coronary arteriography is nowadays more often indicated. Some concepts in coronary heart disease have been reviewed, specially those related to acute coronary syndromes. Non-ST-segment elevation myocardial infarction (previously called non-Q wave myocardial infarction) and unstable angina are now considered "unstable acute coronary syndromes" and both have the same guidelines for management. The main indications for coronary arteriography as the first diagnostic tool are: 1) incapacitating angina, even in stable patients; 2) high-risk patients with unstable coronary syndromes (refractory angina, troponin elevation, new ST- segment deviations, cardiac failure and serious arrythmias); 3) patients with acute ST-elevation myocardial infarction that will be submitted to primary angioplasty or with hemodynamic instability or persistent ischemia. Low-risk patients (angina that promptly subsides after medication, no electrocardiographic or laboratorial changes or atypical chest pain) may be submitted to non-invasive testing for further risk stratification; if no ischemia is detected, coronary arteriography is not indicated and optimized medical treatment is perfectly admitted for a great number of patients. The indications of coronary arteriography for the diagnosis and prognosis of coronary heart disease are not well delimited in clinical practice, and this method is frequently used as the first tool in the investigation of chest pain, even when the characteristics of pain are not exactly those of angina. In this review, the authors discuss the main indications of coronary arteriography in the multiple clinical aspects of coronary heart disease and in the differential diagnosis of chest pain.

Perfil De Pacientes Submetidos Ao Cateterismo Cardíaco: Subsídio Para Prevenção De Fatores De Risco Cardiovascular

“…Em várias situações clínicas da doença se faz necessário conhecer o padrão arterial e função ventricular para ser definido o melhor tratamento. Nesse contexto está indicado o cateterismo cardíaco (7) ; procedimento no qual são introduzidos cateteres em artérias ou veias periféricas, sob anestesia local, levando-os até o coração, com finalidade de diagnóstico denominado de angiografia e de terapêutica mencionada de Angioplastia Coronária Percutânea Transluminar (PTCA) para a DAC (8) .…”

Intervenção psicológica vídeo-orientativa em pacientes submetidos ao cateterismo cardíaco

“…Para confirmação diagnóstica de doença coronária e definição de estratégias terapêuticas mais adequadas a fim de melhorar o prognóstico dos pacientes, está indicada a cinecoronariografia, também conhecida como angiografia coronária ou cateterismo (Solimene & Ramires, 2003). O cateterismo cardíaco é um exame diagnóstico que consiste na introdução de um cateter até o coração, através de uma artéria periférica localizada nos membros superiores ou na região da virilha.…”

Indicação de cintilografia de perfusão do miocárdio para a detecção de doença arterial coronariana, baseada em evidências ergométricas e clínico-epidemiológicas

“…Coronary Artery Disease (CAD) is one of the main causes of mortality and morbidity in the world 4 . Its diagnosis is important, in order to establish the necessary treatment and prevent the consequences of the disease.…”