Diagnóstico temprano del infarto agudo de miocardio en el primer y segundo nivel de atención

Abstract

Introduction: Between 2% and 4% of patients who come to consultation with chest pain will have unstable angina or myocardial infarction. At the first level of care, clinical decision rules such as the Marburg Heart Score and INTERCHEST can help estimate the risk of cardiac ischemia, which allows us to identify when to refer the patient to a higher health level, where resources are available. such as the electrocardiogram and cardiac biomarkers, in order to establish a more accurate diagnosis. Objective: Describe the diagnostic means available for acute myocardial infarction at the first and second level of care, through the review of scientific articles in the last 5 years, to have a broad vision of the resources available. at each level of care and contribute to early diagnosis. Methodology: A review of scientific articles in high-impact journals in databases such as Pubmed and Google Scholar, in the last 5 years, related to the diagnosis of acute myocardial infarction in the first and second level of care was carried out. Conclusion: Currently there is no diagnostic method that allows safely ruling out acute myocardial infarction at the first level of care; clinical prediction scales have negative predictive value. At the second level of care, with the correct interpretation of the electrocardiographic changes and troponin values, the diagnosis is obtained and subsequently referred to a higher level for the respective therapeutic management.