[Therapeutic options in XXXX ].

@entity1 @entity1188 @entity583 @entity1455 @entity121
@entity1455 continues to be a clinical situation which is related with high mortality. Although its etiology is varied, the most frequent cause is an acute @entity583 . The poor prognosis of @entity1455 can be favourably modified with the diagnosis of the underlying cause followed by the stabilization of the @entity1 and early revascularization. Early treatment with inotropic or vasopressor drugs improves the condition of most @entity1 and the use of circulatory assistance, such as the intraaortic balloon, lead to an acceptable hemodynamic situation in 80% of cases. However, they do not significantly modify the mortality rates. In addition, thrombolytic therapy does not appear to be effective for this kind of @entity1 . Only revascularization methods have proved to be effective; surgery is the only option where ventricular septal, free wall, or @entity121 occurs, resulting in survival rates of between 50 and 60% with coronary artery by-pass surgery. Angioplasty is frequently successful in reperfusion of the @entity1188 ; the survival rate in these cases is approximately 70%, according to the different series published. As the mortality rate is exceedingly high (70-90%) when conventional therapy is used; when appropriate diagnostic and therapeutic means are available and when the @entity1 's condition is recoverable, the attitude should be aggressive and coronary angiography and angioplasty applied as soon as possible. In centers where these means are not available, once measures have been taken to achieve the stabilization of the @entity1 , the most suitable procedure is to transfer him or her to a hospital in which qualified staff and such treatment methods are available.
