RESUMEN
A 47-year-old woman complained of angina-like chest pain, near-syncope, and syncopal episodes of 17 years' duration. Physical examination was unremarkable. A 12-lead resting ECG showed symmetrically inverted T waves in the inferior and anterolateral leads. A graded treadmill exercise stress test precipitated angina-like chest pain accompanied by a near-syncopal episode associated with a systemic arterial pressure of 60/40 mm Hg. Echocardiography disclosed left ventricular apical obliteration. Left ventriculogram showed a typical "ace of heart'' shadow as well as filling defects and apical obliteration. Endomyocardial biopsy of the left ventricle diagnosed left ventricular endomyocardial fibrosis. Thus, angina-like chest pain and near-syncopal episodes should be added to the list of clinical manifestations of pure left ventricular endomyocardial fibrosis.
Asunto(s)
Dolor en el Pecho/etiología , Fibrosis Endomiocárdica/diagnóstico , Síncope/etiología , Disfunción Ventricular Izquierda/diagnóstico , Fibrosis Endomiocárdica/complicaciones , Femenino , Humanos , Persona de Mediana Edad , Disfunción Ventricular Izquierda/complicacionesRESUMEN
Na área rural do nunicípio de Teresina-Piauí, foram capturados 129 triatomíneos distribuídos em (a) ecótopos artificiais: habitaçöes (1 Triatoma brasilensis, 1 Panstrongylus geniculatus, 1 Rhodnius pictipes e 1 Rhodnius prolixus) e galpäo abandonado (7 Rhodnius nasutus) e (b) ecótopos naturais: Orbignya martiana (41 Rhodnius neglectus, 33 Rhodnius prolixus e 41 Rhodnius nasutus) e Copernicia cerifera (3 Rhodnius neglectus). Cerca de 22,6 por cento dos triatomíneos capturados estavam infectados por flagelados, sendo 30 por cento no ambiente artificial e 21,9 por cento no ambiente natural. Dos 28 mamíferos capturados e examinados, 7 Didelphis albiventris, 2 Rattus rattus e I Tamandua tetradactyla apresentavam-se positivos para flagelados. Os flagelados encontrados nos triatomíneos e nos mamíferos eram semelhantes ao Trypanosoma cruzi. Das 123 reaçöes sorológicas, por imunofluorescência indireta, realizadas na populaçäo, duas (1,6 por cento) foram reativas