UNIVERSIDAD DE SONORA

LICENCIATURA EN MEDICINA

CARDIOLOGA

Angina e Infarto
Agudo del Miocardio

Albarran | Barragan | Santos | Soto | Trejo

 Infarto del
miocardio
con elevacin
del segmento
ST

Entidad diagnosticada frecuentemente
 LIMITACIN DEL TAMAO DEL INFARTO

Penumbra isqumica
Las demandas de Oxgeno por el miocardio
Se evita la acumulacin de metabolitos
Accin de mediadores de la lesin por revascularizacin
(Ca y radicales libres)

33% de sujetos con STEMI pueden obtener revascularizacin

espontnea de la arteria coronaria en un plazo de 24 h.
La restauracin temprana y oportuna del flujo en la arteria
epicrdica que riega la zona del infarto, en combinacin con una
mejor circulacin de la zona corriente abajo del miocardio
infartado, limita el tamao y el volumen del infarto.
 Intervencin Coronaria Percutnea
Primaria

Angioplastia, colocacin de endoprtesis, o ambos

mtodos, sin fibrinlisis previa
Eficaz si se efecta en las primeras horas del
infarto.
Se prefiere a la fibrinlisis
 Fibrinlisis

Administrar fibrinolticos en un plazo de 30 min de

aparicin del cuadro clnico.
FDA: activador de plasmingeno hstico, estreptocinasa,
tenecteplasa y reteplasa para empleo intravenoso.
Valoracin angiogrfica:
 Fibrinlisis

La administracin de fibrinolticos puede disminuir

el riesgo relativo de fallecimiento hospitalario
hasta en 50% de efectuarse durante la primera hora.
El beneficio se mantiene durante los sig. 10 aos
Mayores beneficios en pacientes tratados de 1 a 3 h
de haber iniciado sntomas.
 Fibrinlisis

tPA bolo de 15
mg, seguidos por El tPA, la rPA y rPA 10 MU por 2
50 mg por la la TNK son ms a 3 min, seguida
misma va en los eficaces que la de otra
primeros 30 min estreptocinasa aplicacin igual
+ 35 mg en los (grado 3 en 30 min despus
60 min sig. TIMI)

Dosis de TNK 0.53 mg/kg

estreptocinasa: en un lapso de
1.5 MU V.I 10 s.
durante 1 h.
Estrategia Integrada de Reperfusin
Contraindicaciones y complicaciones

TRATAMIENTO EN LA FASE HOSPITALARIA

FARMACOTERAPIA

ESTRATIFICACIN DE RIESGOS DESPUS
DE INFARTO Y TRATAMIENTO

PROFILAXIS SECUNDARIA
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Yellow
Is the color of gold, butter
and ripe lemons. In the
spectrum of visible light,
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located between violet and
green on the optical
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sky and the deep sea. It is
located between violet and
green on the optical
spectrum.
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Red
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because of this it has
historically been associated
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