La gestione del paziente con dolore toracico in pronto soccorso
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Abstract
La gestione del dolore toracico è una delle più grandi sfide nei dipartimenti d’emergenza in tutto il mondo. Il sintomo di dolore toracico costituisce la causa più frequente di accesso al Pronto Soccorso (tra il 5-9%) ed è uno dei motivi più comuni di attivazione dei servizi d’emergenza medica: comporta una mortalità elevata (2-4%) in caso di mancata diagnosi e di dimissione impropria.
Gli obiettivi di un percorso adeguato per un paziente con dolore toracico sono quelli di evitare sia la mancata diagnosi o le dimissioni improprie, identificando precocemente i pazienti con dolore toracico di origine coronarica (SCA) ed instaurando un rapido e adeguato trattamento o effettuare velocemente una diagnosi di dolore toracico provocato da un'altra causa. La gestione del dolore toracico necessita di una stretta integrazione e cooperazione tra tutte le figure coinvolte (medici, cardiologi, triagisti, infermieri), compreso il paziente (informazione/condivisone dei percorsi, ecc.)
Il presente documento vuole rappresentare una guida per la gestione in Pronto Soccorso (PS) dei pazienti con dolore toracico non traumatico. Quanto riportato nella presente review è espressione delle più recenti raccomandazioni espresse dalla letteratura internazionale e tiene conto dei percorsi diagnostico-terapeutici condivisi fra le varie Unità Operative e delle Rete Regionali sulle urgenze cardiologiche.
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