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Open Access Research article

Nine-year comparison of presentation and management of acute coronary syndromes in Ireland: a national cross-sectional survey

Frank Doyle*, Davida De La Harpe, Hannah McGee, Emer Shelley and Ronán Conroy

BMC Cardiovascular Disorders 2005, 5:5  doi:10.1186/1471-2261-5-5

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A Clinical Biophysical-Semeiotic Contribution reliable in prompt recognizing CAD, even silent..

Sergio Stagnaro   (2005-02-16 21:01)  Private. Researcher in Biophysical Semeiotics. email

Sir,

all doctors must agree with such as statement: “We need to refine our current strategy to provide optimal treatment for such patients [i.e. with chest pain due to CAD]. Troponin is a blunt screening tool for the assessment of patients with acute coronary syndromes without ST elevation, and we should avoid compounding this by ignoring clinical factors”. A 47-year-long clinical experience allows me to state that we need to refine our current bed-side strategy, learnong the paramount developments of physical semeiotics (See www.semeioticabiofisica.it)although having plenty of laboratory data, to provide precise diagnosis, and optimal treatment for such patients on very large scale. I think that physicians all around the world should identify apparently healthy people, first of all, but really at significant risk of cardiovascular disease, who haven’t yet developed coronary symptoms, and CAD patients,often symptomless, offering them appropriate advice and treatment to reduce their risk or treat their disorder. However, in doing that, we must know and use not only the old, traditional physical semeiotics, as well as laboratory data, but also “all” new developments and advances in physical examination, realized in last 5 decades (1-7) (See the above-cited web site www.semeioticabiofisica.it).

Firstly, aiming to prevent CAD on very large scale, we need a new physical tool easy to apply and reliable in recognizing individuals at "real risk" for CAD, who must undergo suddenly to correct diet, ethymologically speaking, including physical excercise, in order to maintain body weight (BMI) in normal ranges. Secondly, meeting a patient with chest pain we are able now-a-day to assess the real nature and seriousness of the disorder (2, 3, 6, 7). In a few words, such as clinical tool permits doctors to assess in a quantitative way CAD episodes, also by means of stress tests. In conclusion, it is necessary for us a new Weltanschauung in both recognizing and evaluating, in identical and quantitative way, patients involved by CAD, that represents the “conditio sine qua non” for optimal, adequate, and prompt management.

1) Curzen N. Troponin in patients with chest pain

BMJ 2004;329:1357-1358 (11 December), doi:10.1136/bmj.329.7479.1357

2) Stagnaro S A clinical efficacious maneouvre, reliable in bed-side diagnosing coronary artery disease, even initial or silent, as well as “heart coronary risk”. 3rd TCVC Argentine Congress of Cardiology, September 2003 . http://www.fac.org.ar/tcvc/marcoesp/marcos.htm3) Stagnaro-Neri M., Stagnaro S., Auscultatory Percussion Evaluation of Arterio-venous Anastomoses Dysfunction in early Arteriosclerosis. Acta Med. Medit. 5, 14, 1989.

4) Stagnaro-Neri M., Stagnaro S., Deterministic Chaos, Preconditioning and Myocardial Oxygenation evaluated clinically with the aid of Biophysical Semeiotics in the Diagnosis of ischaemic Heart Disease even silent. Acta Med. Medit. 13, 109, 1997.

5) Stagnaro-Neri M., Stagnaro S., Acidi grassi Omega-3, scavengers dei radicali liberi e attivatori del ciclo Q e della sintesi del Co Q10. Gazz. Med. It. – Arch. Sc. Med. 151, 341,1992 (Medline).

6) Stagnaro S. Pivotal role of Biophysical Semeiotic Constitutions in Primary Prevention.

Cardiovascular Diabetology.2003, 2:1,

http://www.cardiab.com/content/2/1/13/comments#5753

7) Stagnaro Sergio, Stagnaro-Neri Marina. Introduzione alla Semeiotica Biofisica. Il Terreno oncologico”. Travel Factory SRL., Roma, 2004. http://www.travelfactory.it/semeiotica_biofisica.htm

Competing interests

Not declared

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