Elementi predittivi:un nuovo ausilio l’ECG

Dipartimento di CardiologiaUnita’ Operativa di EmodinamicaNuovo Ospedale S.Agostino-Estense Modena Italia

Dr. Carlo Cappelli

Esiste un ruolo dell’ECG nel 2009 ad oltre 100 anni dalla sua scoperta per la stratificazione del rischio nel soggetto con Sindrome Coronarica Acuta?

Linee guida SCA 2002

Sopraslivellamento tratto ST

PRE OCCLUSIONE IVA proxPOST PTCA SU RAMO IVA

Ischemia subepicardica anteriore 1

Uomo 78 anni, iperteso, asintomatico. ECG di routine.

Stenosi critica con trombo fluttuante in ramo IVA

Ischemia subepicardica anteriore 2

Uomo di 72 anni, con IMA non-Q e TnI = 2,5

Aneurisma ramo IVA

Sottoslivellamento tratto ST

UOMO 74 ANNI, FUMATORE ED IPERTESO, Tn I positiva

Stenosi critica T.C.

Bavry, A. A. et al. J Am Coll Cardiol 2006;48:1319-1325

Relative risk of all-cause mortality for early invasive therapy compared with conservative therapy at a mean follow-up of

2 years

Bavry, A. A. et al. J Am Coll Cardiol 2006;48:1319-1325

Relative risk of all-cause mortality for early invasive therapy compared with conservative therapy as a

function of time

Ischemia 3

The Future ?

New Intervention Technique…

““Every time a new Every time a new intervention technique intervention technique is proposed, a new is proposed, a new complication or adverse complication or adverse effect is expected to effect is expected to occur. It is just a occur. It is just a matter of time! In that matter of time! In that situation, our efforts situation, our efforts have to be focused on have to be focused on how to identify, to how to identify, to minimize, to avoid it!minimize, to avoid it!””

E.Sosa, et al. Left E.Sosa, et al. Left atrialatrial--esophagealesophageal fistula ... fistula ... JCE, 2005.JCE, 2005. Modena Cathedral

Ischemia 4