Abordagem das síndromes coronarianas agudas em idosos em hospital geral do SUS

Abstract

INTRODUCTION: The acute coronary syndromes (ACS) cover a spectrum of diseases, which include the silent ischemia, unstable angina and acute myocardial infarction (AMI) with or without ST-segment elevation. Coronary artery disease is the leading cause of death worldwide and its prevalence has been increasing progressively as a result of the increase in life expectancy and the survival of acute cases. OBJECTIVE: To analyze the approach performed by the SUS in elderly with acute coronary syndrome in a general hospital. METHODS: A cross-sectional study with a sample consisting of 31 elderly patients older than 60 years who were presented with clinical symptoms compatible with acute coronary artery disease with or without ST-segment elevation in 12-lead electrocardiogram with up to 07 days of evolution in the Deputado Janduhy Carneiro hospital in Patos-PB. The analysis was descriptive in all the variables of the study. RESULTS: From the sampled patients, 22 (71%) were female, the predominant age range was from 71 to 80 years in 16 (51,6%) of the cases. The most prevalent risk factors found were hypertension, 27 cases (87.1 %), family history of coronary artery disease, 18 cases (58.1 %) and diabetes mellitus, 08 cases (25.8 %). There was an association with high mortality for patients classified in Killip class III and high risk in TIMI Risk score. Only nine (36 %) patients with myocardial infarction with ST segment elevation did therapy recanalization with fibrinolytic therapy. Medications such as beta-blockers and heparin were used less in the admission and medications such as aspirin, betablockers, angiotensin-converting enzyme inhibitors and statins are no longer prescribed frequently in hospital discharge. There was a high mortality of elderly patients (35.5% of cases) found in the study. CONCLUSION: The problems detected in the elderly with SCA collide in the precariousness of the health model and does not follow the current guidelines. It is evident, therefore, the need for new standards of care in health care with implementation of public policies since the emphasis on prevention of cardiovascular risk factors, in the training of health professionals to the use of therapies that have proven effective for reducing this high mortality.