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SM ISO690:2012 FILIMON, Silvia, GRIB, Liviu, GREJDIERU, Alexandra, GRĂJDIERU, Romeo, GRIB, Andrei, SAMOHVALOV, Elena. Particularități de prezentare clinică a sindromului coronarian acut la pacient cu multipli factori de risc cardiovascular. In: Congresul consacrat aniversării a 75-a de la fondarea Universității de Stat de Medicină şi Farmacie „Nicolae Testemiţanu”, 21-23 octombrie 2020, Chişinău. Chişinău: USMF, 2020, p. 219. |
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Congresul consacrat aniversării a 75-a de la fondarea Universității de Stat de Medicină şi Farmacie „Nicolae Testemiţanu” 2020 | ||||||
Congresul "Congresul consacrat aniversării a 75-a de la fondarea Universității de Stat de Medicină şi Farmacie „Nicolae Testemiţanu”" Chişinău, Moldova, 21-23 octombrie 2020 | ||||||
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Pag. 219-219 | ||||||
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Background. Almost two-thirds of all ischaemic episodes in the phase of instability are clinically silent, and hence are unlikely to be detected by a standard ECG. In clinical suspicion of ACS, negative tests of cardiac biomarkers will be repeated and coronary angiography is mandatory. Objective of the study. Determining the particularities of clinical presentation of acute coronary syndrome in patient with multiple risk factors. Material and Methods. Man, 47 years old, smoker, overweight (BMI- 29 kg/m2), with second degree AH and type 2 DM, presented at hospitalization with retrosternal constrictive pain at minimal physical effort and at rest, duration over 30 min., radiating in the neck; inspiratory dyspnea at minimal physical effort, palpitations, weakness. The onset of angina pectoris (AP)- 14 days. Results. ECG- sinus rhythm with HR-74 bpm. EAH- intermediate. Signs of LV hypertrophy. EcoCG- normal- sized heart, LV hypertrophy (IVS-13,5 mm, LWLV-12,5 mm), without wall motion abnormalities. Cardiac biomarkers (Troponin T, CK-MB) were within the norm. Coronary angiography - serial stenoses on LAD with unstable plaque appearance. Coronary angioplasty was performed with implantation of the pharmacologically active stent (everolimus) on LAD I-II with the reduction of the stenosis degree from 90% to 0%. Discharged at home without AP access, with the administration of beta-adrenoblockers, dual antiplatelet therapy, nitrates, ACEI, insulin therapy. Conclusion. In patients with multiple cardiovascular risk factors, the ECG and EcoCG do not always show data of acute myocardial ischemia, and coronary angiography helps us to determine the degree of damage to the coronary arteries and with their correction. |
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Cuvinte-cheie acute coronary syndrome, cardiovascular risk factors, sindrom coronarian acut, factori de risc cardiovascular |
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