Teoria Taller Jornadas R3 SAMFyC
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Transcript of Teoria Taller Jornadas R3 SAMFyC
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Francisco José Guerrero GarcíaMédico de Familia
UGC Gran Capitán. Granada05 de Marzo de 2009
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OBJETIVOS● Identificar correctamente los SCA.
● Conocer sistemática de atención inicial al SCA
● Conocer el Tratamiento específico del SCACEST y del SCASEST
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EPIDEMIOLOGÍA
● Primera causa de mortalidad en Andalucía, al igual que en el resto de España y en general en los países occidentales
● En España fueron responsables del 35% del total de defunciones del año 2000(30% en hombres y 40% en mujeres)1, cifra que se eleva al 38% en la Comunidad Autónoma de Andalucía (33% en hombres y 45% en mujeres)1.
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www.youtube.com/watch?v=22bDs8teiZA&feature=related
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ALTERACIONES ELECTROCARDIOGRÁFICAS EN
LOS SÍNDROMES CORONARIOS
ÁGUDOS
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•ISQUEMIA
•LESIÓN
•NECROSIS
TIPO DE LESIÓN
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•Falta de aporte de O2 al miocardio.
•Tipos:
•Subepicárdica
•Subendocárdica
ISQUEMIA
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ISQUEMIA SUBEPICÁRDICA
• Alteraciones electrocardiográficas:– ondas T negativas generalmente picudas
aunque en las primeras fases pueden aparecer aplanadas.
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ISQUEMIA SUBENDOCÁRDICA
• Alteraciones electrocardiográficas:– ondas T positivas picudas aunque en las
primeras fases pueden aparecer aplanadas.
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LESIÓN SUBEPICÁRDICA
• Elevación del segmento ST
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LESIÓN SUBENDOCÁRDICA
• Descenso del segmento ST
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NECROSIS
• Aparición de onda Q de necrosis:– Duración > o = a 0,04 seg– Voltaje superior al 25 % de la onda R– Localizada en situación anormal.
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LOCALIZACIÓN DEL IAM
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INFARTO ANTERIORArteria coronaria izquierda
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INFARTO INFERIOR
Arteria coronaria derecha
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INFARTO LATERAL
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INFARTO POSTERIOR
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LOCALIZACIÓN DE COMBINACIONES DE INFARTOS
V1
LATERALANT
POST ANT
SEPTAL
ANT
LAT
INFERIOR
aVR V4I
II
III
aVL
aVF
V2
V3
V5
V6
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