Protocolo de atendimento de dor torácica em pediatria
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Data
2018-07-31
Autores
Polo, Mariana Colbachini
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Universidade Estadual Paulista (Unesp)
Resumo
Dor torácica na faixa etária pediátrica é causa comum de atendimentos em Pronto-Socorros e de encaminhamento para cardiologistas. Em crianças e adolescentes, com pouca frequência o sintoma está relacionado à patologia cardíaca, sendo as etiologias idiopática, musculoesqueléticas, gastrointestinais, pulmonares e psicogênicas as mais prevalentes. Embora seja benigna na maioria dos casos, tal sintoma pode ser responsável por faltas escolares, restrição das atividades físicas e pode ainda causar muita ansiedade em pacientes, familiares e profissionais da saúde. Anamnese, exame físico e eletrocardiograma conseguem identificar os pacientes com doenças que precisam ampliar a investigação diagnóstica, com exames ou avaliação do cardiologista pediátrico, sem necessidade de outros exames iniciais. Apesar disso, o medo e a ansiedade de perder uma condição potencialmente fatal levam a avaliações que são de baixo rendimento, alto custo, além de sobrecarregar os serviços especializados. Protocolos para padronização da abordagem da dor torácica pediátrica estão sendo implementadas em diversos departamentos de cardiologia pediátrica em todo o mundo visando a reduzir a grande variação das condutas adotadas na investigação diagnóstica, otimizar a utilização de recursos e melhorar o atendimento aos pacientes. Objetivo: Padronizar um protocolo de atendimento de dor torácica na faixa etária pediátrica de acordo com a realidade institucional do Hospital das Clínicas da Faculdade de Medicina de Botucatu, baseado nas melhores evidências disponíveis na literatura. Metodologia: Estudo de revisão da literatura realizado nas principais fontes: Pubmed, Embase, LILACS, Cochrane e Uptodate. Resultado: Foi elaborado um algoritmo de atendimento de dor torácica pediátrica que estará à disposição dos médicos responsáveis pelo atendimento aos pacientes pediátricos da instituição. Conclusão: A investigação diagnóstica padronizada de dor torácica em pediatria poderá proporcionar a otimização dos recursos hospitalares, além do diagnóstico e tratamento mais adequado.
Pediatric chest pain is a common cause of emergency department (ED) visit and cardiology referral. In children and adolescents this symptom is infrequently related to a cardiac pathology, and more often, its causes are: idiopathic, musculoskeletal, gastrointestinal, pulmonary and psychogenic. Although it´s mostly benign, such sign may yet be responsible for school absence, lack of physical activities and parental anxiety. Background history, physical examination and electrocardiogram can easily identify the patients who need further investigation, whether if they need more exams or a cardiology referral. However, many of those patients are submitted to unnecessary exams because physicians fear that the initial assessment will not be enough, which implicates in money expenditure and overloaded specialty hospitals. Protocols to support decision-making and standardized assessment are being implemented in many cardiology departments, resulting in reduced costs and improved patient well-being. Objectives: Implementation of an evidence based pediatric chest pain protocol according to the resources available in Botucatu Medical School. Methods: Computer-based search of Pubmed, EMBASE, LILACS, Cochrane and Uptodate. Data summary: An algorithm of pediatric chest pain care was developed and that will be available to physicians responsible for the pediatric patients of the institution. Conclusions: The standardized assessment of pediatric chest pain can reduce hospital costs, in addition to the diagnosis and more appropriate treatment .
Pediatric chest pain is a common cause of emergency department (ED) visit and cardiology referral. In children and adolescents this symptom is infrequently related to a cardiac pathology, and more often, its causes are: idiopathic, musculoskeletal, gastrointestinal, pulmonary and psychogenic. Although it´s mostly benign, such sign may yet be responsible for school absence, lack of physical activities and parental anxiety. Background history, physical examination and electrocardiogram can easily identify the patients who need further investigation, whether if they need more exams or a cardiology referral. However, many of those patients are submitted to unnecessary exams because physicians fear that the initial assessment will not be enough, which implicates in money expenditure and overloaded specialty hospitals. Protocols to support decision-making and standardized assessment are being implemented in many cardiology departments, resulting in reduced costs and improved patient well-being. Objectives: Implementation of an evidence based pediatric chest pain protocol according to the resources available in Botucatu Medical School. Methods: Computer-based search of Pubmed, EMBASE, LILACS, Cochrane and Uptodate. Data summary: An algorithm of pediatric chest pain care was developed and that will be available to physicians responsible for the pediatric patients of the institution. Conclusions: The standardized assessment of pediatric chest pain can reduce hospital costs, in addition to the diagnosis and more appropriate treatment .
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recém-nascido, pediatria, criança, adolescente, dor torácica, diagnóstico, tratamento, chest pain, diagnosis, treatment, pediatrics, newborn, children, adolescents