RESUMEN
We report a case of acute inferior myocardial infarction caused by occlusion of an anomalous right coronary artery, successfully treated with primary angioplasty. When an anomalous origin of a coronary artery is suspected, it is crucial to perform aortic angiography or left ventriculography in multiple projections.
Asunto(s)
Angioplastia Coronaria con Balón/métodos , Angiografía Coronaria , Anomalías de los Vasos Coronarios/diagnóstico por imagen , Infarto del Miocardio/terapia , Tomografía Computarizada por Rayos X , Anticoagulantes/uso terapéutico , Aortografía , Aspirina/análogos & derivados , Aspirina/uso terapéutico , Cateterismo Cardíaco/instrumentación , Cateterismo Cardíaco/métodos , Clopidogrel , Angiografía Coronaria/métodos , Anomalías de los Vasos Coronarios/complicaciones , Electrocardiografía , Femenino , Humanos , Lisina/análogos & derivados , Lisina/uso terapéutico , Persona de Mediana Edad , Infarto del Miocardio/etiología , Inhibidores de Agregación Plaquetaria/uso terapéutico , Arteria Radial , Stents , Ticlopidina/análogos & derivados , Ticlopidina/uso terapéuticoRESUMEN
BACKGROUND: Informed consent must be obtained from all patients undergoing medical procedures, especially when these imply a significant risk of severe adverse events. However, as for interventional cardiology, recall of information has been shown to be poor. In this study we evaluated the usefulness of an audiovisual support, in adjunct to the standard written informative form, in obtaining: (a) effective patient information before invasive coronary procedures, and (b) patient familiarization with the cath lab team, equipment, and the main procedural phases. METHODS: The audiovisual informative support was carried out through explicative interviews to the operators of the cath lab, animations, and realistic visualization of the procedural phases. Patient information was evaluated with a multiple-choice questionnaire. Self-assessment of the patient's emotional state was also evaluated using a semiquantitative scale. RESULTS: Patients receiving the audiovisual support in adjunct to written informative form showed a significantly lower rate of erroneous answers at the multiple-choice questionnaire with respect to patients receiving just written informative form (1.1 +/- 1.0 vs. 3.2 +/- 1.7; p < 0.001). Moreover, patients informed through the audiovisual support showed a slight, although statistically significant, reduction in semiquantitative indexes of anxiety (p = 0.0021) and experienced pain (p = 0.034). CONCLUSIONS: The use of an audiovisual support may favor patient's adequate information prior to written consent and, when prepared by the cath lab team operators, it may optimize his emotional state through a "familiarization effect".