Abstract
Objetivo
Conocer el grado de información que tienen los pacientes con cardiopatía isquémica (CI) y su actuación ante situaciones de alarma (dolor torácico de perfil isquémico en esfuerzo, en reposo, agravamiento en esfuerzo, de más de 20 min), el manejo que hacen de la nitroglicerina sublingual (NTGSL) y la fuente de dicha información.
Diseño
Estudio descriptivo transversal basado en entrevista personal y cuestionario de elaboración propia, durante septiembrediciembre de 2001.
Emplazamiento
Atención primaria. Seis consultas de tres zonas básicas de salud urbanas.
Participantes
Muestra aleatoria de 98 pacientes con CI (angina estable, inestable, angina con infarto).
Mediciones y resultados
Encuestados: 93 (57 varones, 36 nujeres). Edad media: 71 ± 19. Con diagnóstico de infarto: 34. No disponen de NTGSL el 17,2% (IC del 95%: 9,5–24,9%). Desconocen cuándo acudir a urgencias hospitalarias con angina de esfuerzo y reposo el 78,5% (IC del 95%: 70,2–86,8%) y el 81,7% (IC del 95%: 73,8–89,6%), respectivamente. El 37,8% (IC del 95%: 26,8–48,8%) con angina de esfuerzo progresiva acudiría urgentemente a su médico o al hospital. No recibió información ante angina de reposo, esfuerzo progresivo y de más de 20 min el 100% de los pacientes. No existe diferencia sobre la actuación ante angina de esfuerzo entre pacientes informados por primaria o especializada, sí en el buen uso de NTGSL entre infartados y no infartados (p = 0,003).
Conclusiones
Nuestros cardiópatas no reconocen con prontitud los síntomas de alarma; por tanto, no obtienen el máximo beneficio del tratamiento hospitalario. Ningún médico (primaria, especializada) les informó de la diferente actuación ante angina estable e inestable. Sólo una mínima parte usa bien la NTGSL en angina de esfuerzo y saben cuándo acudir a urgencias. Inminente necesidad de mejorar la educación sanitaria de nuestros cardiópatas.
Palabras clave: Cardiopatía isquémica, Síntomas de alarma, Educación sanitaria, Fuente de información, Nitroglicerina sublingual
Abstract
Objectives
To find the degree of information that patients with ischaemic cardiopathy (IC) possess and their behaviour on alarm symptoms (thoracic pain of ischaemic profile under stress, at rest, worsening under stress and for over 20’), how they manage sublingual nitro-glycerine (SLNTG), and the source of their information.
Design
Transversal descriptive study based on personal interview and our own questionnaire, from September to December 2001.
Setting
Primary Care. Six clinics in three urban Health Areas.
Participants
Randomised sample of 98 patients with IC (stable angina, unstable angina, angina with infarct).
Measurements and results
93 people (57 male, 36 women) were surveyed. Their average age was 71 ± 19.34 had diagnosis of infarct. 17.2% (95% CI, 9.5%–24.9%) had no SLNTG available. 78.5% (95% CI; 70.2%–86.8%) and 81.7% (95% CI; 73.8%–89.6%) of those with angina under stress or at rest, respectively, did not know when to attend the hospital Emergency department. 37.8% (95% CI, 26.8%–48.8%) with steady stress angina would attend a hospital or their doctor urgently. 100% of patients had received no information on angina at rest, under steady stress and for over 20’. There was no difference in behaviour before stress angina between patients who had been informed by Primary Care and those informed by Specialists. There was a difference, though, for good use of SLNTG between infarct and non-infarct patients (p = 0.003).
Conclusions
Our cardiopaths do not recognise alarm signals quickly; and so do not benefit as well as they might from hospital treatment. No doctor (Primary Care or specialist) informed them of the different ways to confront stable and unstable angina. Only a very small number used SLNTG in stress angina properly and knew when to attend Casualty. There is an urgent need to improve the health education of our cardiopaths.
Key words: Ischaemic cardiopathy, Alarm symptoms, Health education, Source of information, Sub-lingual Nitro-glycerine
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