title: Prehospital evaluation and treatment of a presumed acute coronary syndrome: what are the options?
abstract: The earlier infarct-limiting therapy is started the better is the outcome among patients suffering from a threatened myocardial infarction. The introduction of a prehospital electrocardiogram has improved triage of patients with acute chest pain. With regard to medication, fibrinolytic agents have the best documentation. Their use when frequently followed by a percutaneous coronary intervention at a later stage may be a good alternative among patients with ST-elevation myocardial infarction. Other treatments of potential value in the prehospital setting are oxygen, narcotic analgesics, nitrates, aspirin, heparin, low molecular weight heparin, glycoprotein IIB, IIIA blockers, clopidogrel and beta-blockers. We need further studies, however, for most of these treatments including cost-benefit analysis, analysis of various logistic aspects and safety in order to confirm their value.
authors.affiliation: Division of Cardiology, Sahlgrenska University Hospital, Göteborg, Sweden. johan.herlitz@hjl.gu.se
authors.forename: Johan
authors.initials: J
authors.lastname: Herlitz
authors.forename: Leif
authors.initials: L
authors.lastname: Svensson
mesh_terms: D015415:Biomarkers / Q000097:blood; D004562:Electrocardiography; D004632:Emergency Medical Services; D004638:Emergency Treatment / Q000379:methods*; D006801:Humans; D009203:Myocardial Infarction / Q000175:diagnosis / Q000628:therapy*
chemical_list: D015415:Biomarkers