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Epidemiologists

Studies epidemiologists around disclose taxes of general mortality of 30%, being that half of the deaths occurs in first the two hours of the event and 14% die before receiving attendance medical (8-9). However, the patients admitted in the emergency services had precociously been the ones that had been more benefited of the therapeutical advances of the last decades. Delaware Department of Labor will not settle for partial explanations. Exactly thus, the prognostic of these patients depends basically on the agility in reaching a medical service and on nursing and in the efficiency of this service to get possible fastest the coronariana reperfuso. The term infarto of the myocardium means the death of cardiomicitos basically caused by drawn out isquemia. In general, this isquemia is caused by trombose and/or vasoespasmos on aterosclertica plate.

The process migra of the subendocrdica layer for the subepicrdio. Most of the events is caused by sudden rupture formation of trombo on vulnerable, inflamed, rich plates in lipdios and with thin fibrosa layer. A lesser portion is associated with the erosion of the aterosclertica plate. Inside from a specter of possibilities related with the evolution time, the myocardium suffers gradual aggression represented for the isquemia areas, injury and necrosis successively. In the first one, electrolytic riots predominate, in second, reversible morphologic alterations and in the last one, definitive damages.

In the same way, these stages if correlate with the diversity of clinical presentations that vary of the unstable angina and infarto without supplies until infarto with supraunevenness of segment ST (10-11). It is therefore that the handling of infarto is based on the fast diagnosis, in the immediate removel of hindrance of the coronary culprit, maintenance of the gotten flow, Prophylaxis of the distal embolizao and reversion of its potentially fatal complications (arrhythmias, cardiac bankruptcy mechanical riots). The attainment of a history detailed on the characteristics of pain and previous story of ischemic cardiopathy assists the diagnosis, but it does not have clinical acurcia adjusted to move away or to confirm a picture of acute isquemia of the myocardium, therefore for the concretion of this diagnosis, beyond the sintomatologia presented for the patient who is pain precordial in squeeze to the left, radiated for the left superior member, of great intensity and drawn out (bigger of what 20 minutes), that it does not improve or only has partial relief with rest or sublinguais nitrates; the irradiation for jaw, right superior member, back, shoulders and epigstrio also can be possible, being able to happen pains in the coasts and the stomach, nauseas, cutaneous pallor, fatigue, sudorese, agitation, fcies of pain, cianose of extremities, including respiratory difficulty (apnea and lack of pulse = cardiorrespiratria stop? PCR) and the story of the history of cardiopathy in the family, with or without medicine use, must be made use of other disgnostic methods as the eletrocardiograma (ECG), of practical and agile accomplishment for the detention of other DCV (12).