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L’insuffisance cardiaque aiguë pp 101–114Cite as

Les marqueurs biologiques dans ľICA

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Part of the book series: Le point sur... ((POINT))

Abstrait

Ľinsuffisance cardiaque aiguë (ICA) est la première cause de dyspnée aiguë aux urgences (environ 50 % des cas) et la première cause ďhospitalisation des sujets âgés (1–5). Son pronostic est sévère avec une mortalité hospitalière ďenviron 10 %, proche de 25 % chez les sujets âgés de plus de 70 ans (1, 2, 5). Le diagnostic ďICA est parfois difficile (2, 5, 6) Cela est particulièrement vrai chez le sujet âgé, obèse ou porteur de broncho-pneumopathie chronique obstructive (BPCO), ou lorsqu’il existe des sibilants lors de ľexamen physique (asthme cardiaque). La sensibilité de ľurgentiste pour le diagnostic positif ďœdème aigu du poumon (OAPc) est inférieure à 70 % dans toutes les études, car les examens complémentaires ne sont pas toujours pertinents, en particulier la radiographie thoracique (RT) (7, 87). Ľéchocardiographie couplée au Doppler est ľexamen non invasif de référence. Mais, malheureusement cet examen est:

  • rarement réalisable en urgence 24h/24; — encore moins fréquemment réalisé chez les sujets âgés;

  • nécessite une analyse Doppler fine avec un opérateur sachant différencier les variations du flux Doppler liées à une surcharge cardiaque des modifications rapportées à ľâge (6).

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Authors and Affiliations

  1. Réanimation polyvalente, CHD Félix Guyon, Allée Topaze, Belle-Pierre, 97400, Saint-Denis Cedex

    Y. Lefort

  2. Service ďaccueil des urgences, Groupe Hospitalier Pitié-Salpêtrière, 47-83, boulevard de ľHôpital, 75013, Paris

    P. Ray

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© 2006 Springer-Verlag France

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Ray, P., Lefort, Y. (2006). Les marqueurs biologiques dans ľICA. In: L’insuffisance cardiaque aiguë. Le point sur.... Springer, Paris. https://doi.org/10.1007/978-2-287-34066-6_8

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  • DOI: https://doi.org/10.1007/978-2-287-34066-6_8

  • Publisher Name: Springer, Paris

  • Print ISBN: 978-2-287-34065-9

  • Online ISBN: 978-2-287-34066-6

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