RESUMEN
Venous thromboembolism (VTE) is a common disease, which includes deep venous thrombosis (DVT) and pulmonary embolism (PE). It is the third most common cardiovascular disorder, affecting predominantly the male elderly population. Stress cardiomyopathy (SC) is a transitorily cardiovascular condition produced after an emotional or physical trigger, and it features signs and symptoms of acute coronary syndrome. Its pathophysiological mechanisms remain unclear, and SC has also been related to critical complications such as heart failure, arrhythmias, left ventricular outflow obstruction, and thromboembolic events. This case report highlights the association of PE and SC that might play a pathophysiological role.
RESUMEN
Background Acute coronary syndrome (ACS) is the leading cause of morbidity and mortality worldwide. The different reperfusion strategies have evolved over the years, and efforts have been directed to reduce its complications. Among these strategies, the one that has shown the best results is percutaneous coronary intervention, which has significantly improved the survival and prognosis of these patients; however, this procedure is not free of complications since multiple factors are involved. Among them is the time of patient care from the time of diagnosis until the coronary reperfusion therapy is performed. Methodology In this study, we describe the experience in our center with the 6-French Ikari Left guide catheter as a strategy of radial angiography-angioplasty with a single catheter to reduce the care times of patients with acute ST-elevation myocardial infarction (STEMI) in our center and compare it with the series reported by other international centers since. To establish an alternative to the usual approach that consists of the use of Judkins catheters, diagnosis, and guiding. Results Our study showed a success rate for diagnostic angiography and percutaneous coronary intervention (PCI) with the 6- French Ikari Left catheter comparable to those obtained in other centers, even with lower complication rates than the usual approach with Judkins' Catheters. Conclusions The use of the 6-French Ikari Left catheter demonstrated shorter needle-device time and compared to other international series, it was shown to be shorter and related to shorter fluoroscopy time. Our study has a small sample and only included a highly selected population, which represents a limitation. This study is vulnerable to the different practices of the operators, with involvement in procedure time and use of contrast volume.
RESUMEN
Background The T-wave alterations are suggestive of ischemia, among them there is the pseudo-normalization (positivization of the T-wave, previously negative, during stress exercise). Myocardial single photon emission computed tomography (SPECT) at rest and stress is usually performed with Technetium 99 (Tc-99), which has high sensitivity and specificity for the detection of ischemic heart disease. In this study, we decided to investigate the patients who pseudo-normalized the T-wave in the stress test to correlate with the existence of ischemia diagnosed by myocardial perfusion study, specifically myocardial SPECT in perfusion and rest with Tc-99. Methodology T - wave pseudo-normalization patients who underwent a myocardial perfusion SPECT between January 2018 and June 2019 were included in this retrospective study. We analyzed 81 patients: 50 patients with pseudo-normalization of T-waves and 31 patients, as a control group, without pseudo-normalization. A descriptive analysis of the quantitative variables was performed using Student's t-test or Mann-Whitney U test, and for the qualitative variables, the χ2 test or Fisher's exact test was performed. Results The degree of ischemia according to the presence or absence of pseudo-normalization of the T-wave. The pseudo-normalization of the T-wave in the group without ischemia (48.4% vs. 36%), for the mild degree the proportions were the same (38.7% vs. 38%), the moderate degree it was slightly higher in the pseudo-normalization of the T-wave (9.7% vs. 18%) and severe (3.2% vs. 6%). Conclusions In this study, the relationship between pseudo-normalization of the T waveform and ischemia, predominantly moderate to severe, was demonstrated. However, it was not statistically significant due to the size of the sample studied.
RESUMEN
Systemic lupus erythematosus (SLE) is an autoimmune disease that can affect any organ with a predisposition for women of reproductive age. It is related to a higher risk of cardiovascular events, increasing it up to 50 times in young people, and 30% of deaths are attributed to coronary artery disease. The risk of developing cardiovascular disease in SLE is related not only to traditional cardiovascular risks factors such as advanced age, hypertension, dyslipidemia, and diabetes but also to disease-specific factors, such as degree of activity, autoantibodies, organ damage, and treatment. Accelerated atherosclerosis is one of the main contributors to pathogenesis. Manifestations range from angina to acute myocardial infarction and sudden death. Markers have been studied for the detection of subclinical disease and stratification of these patients, as well as different treatment options to improve the cardiovascular prognosis of the disease.