RESUMO
UNLABELLED: Several diagnostic tools have been used in the evaluation of the severity transvalvular gradient and aortic valve area. The advances in cardiac catheterization and Doppler echocardiographic measure these items accurately. We designed a retrospective, observational open and transversal survey that included patients with severe aortic stenosis that required transseptal cardiac catheterization. Their echocardiographic and hemodynamic studies were reviewed. From January 1991 to December 1996 we studied 30 patient from a population of 256. All of them with severe aortic stenosis. There were 17 males and 13 females with an age range from 32 a 71 years. RESULTS: the transvalvular gradient measured by catheterization vs. Doppler echocardiogram was 98.80 +/- 37.29 mmHg vs. 96.63 +/- 38.64 mmHg respectively P = 0.84. The valvular area measured by catheterization vs Doppler echocardiographic 0.63 +/- 0.17 cm2 vs 0.62 +/- 0.15 cm2 respectively P = 0.63. There was not difference in the gradients using these two methods. We conclude that patients with severe aortic stenosis could be referred to surgical procedure without the need of cardiac catheterization if no concurrent coronary disease is suspected.
Assuntos
Estenose da Valva Aórtica/diagnóstico , Cateterismo Cardíaco , Ecocardiografia Doppler , Adulto , Idoso , Estenose da Valva Aórtica/fisiopatologia , Estenose da Valva Aórtica/cirurgia , Estudos Cross-Over , Estudos de Avaliação como Assunto , Feminino , Hemodinâmica , Humanos , Masculino , Pessoa de Meia-Idade , Modelos Biológicos , Estudos RetrospectivosRESUMO
This article reports the clinical and angiographic aspects of three patients with congenital coronary arteriovenous fistula to the main pulmonary artery, which manifested as dyspnea crisis and angina. This three cases were found in the course of 4,400 consecutive cardiac catheterization procedures to study coronary artery disease. The interest of the cases reported is based on the peculiar anatomy of the fistula. Prompt diagnosis is relevant for better prognosis and treatment.
Assuntos
Fístula Artério-Arterial/complicações , Aneurisma Coronário/complicações , Isquemia Miocárdica/etiologia , Artéria Pulmonar , Fístula Artério-Arterial/diagnóstico por imagem , Aneurisma Coronário/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Isquemia Miocárdica/diagnóstico por imagem , Artéria Pulmonar/diagnóstico por imagem , Radiografia , Estudos RetrospectivosRESUMO
The use of antibiotics in patients who undergo cardiac catheterization, by percutaneous approach, using re-sterilized catheters, is controversial, and there is not clear information in this regard. We investigated the frequency of bacteremia during cardiac catheterization and the evidence of later infection, using re-sterilized material. We studied 227 consecutive patients over one year, and we obtained 200 blood cultures of the beginning and the end of the procedure. All the cultures were negative and there was not evidence of clinical infection in the year following the study. These results indicated that bacteremia is rare during cardiac catheterization, if aseptic technics are followed. Based on these result we do not recommend the use of antibiotics in patients undergoing cardiac catheterization. The sex, age, type of heart disease and re-sterilized material do not alter this recommendation.
Assuntos
Antibacterianos/uso terapêutico , Cateterismo Cardíaco , Pré-Medicação , Adolescente , Adulto , Idoso , Bacteriemia/epidemiologia , Bacteriemia/prevenção & controle , Cateterismo Cardíaco/efeitos adversos , Cateterismo Cardíaco/instrumentação , Cateterismo Cardíaco/métodos , Contraindicações , Contaminação de Equipamentos/estatística & dados numéricos , Feminino , Seguimentos , Humanos , Incidência , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Estudos Prospectivos , Esterilização/estatística & dados numéricosRESUMO
The objective of this study is to determine the prognostic value of stress testing in patients with coronary heart disease. We examined 95 cases followed during an average period of 33 months. The age was 52 +/- 9 years. All patients had clinical evidence of myocardial ischemia: 78 had previous myocardial infarction, 11 stable angor pectoris and six unstable angina. After the initial event 33 patients were asymptomatic and 62 with mild angina. During follow-up; 42 patients had no coronary events; 10 died, six developed non-fatal myocardial infarction and 37 had more angina, nine of these patients were treated with bypass coronary artery surgery. The annual mortality was 3.8%, all with previous myocardial infarction. In the stress testing the patients who died were distinguished by limited exercise ability and severe changes of ST-T segment. Patients with greater than or equal to 0.2 mV ST-T segment depth or effort duration less than or equal to 3 minutes had an annual mortality F 7% 13.6% respectively.
Assuntos
Doença das Coronárias/fisiopatologia , Adulto , Idoso , Eletrocardiografia , Teste de Esforço , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , PrognósticoRESUMO
Se comunican 12 casos de aparente angor pectoris (cuyo estudio coronariografico fue normal), cuyas edades variaron de 33 a 60 anos, con una media de 50.6. Ocho pertenecian al sexo femenino y 4 al masculino. El diagnostico de angor fue hecho en base a la historia clinica. Fue considerado con caracter estable en 3 casos y en 9 inestable. El electrocardiograma (ECG) de reposo mostro signos de isquemia subepicardica en 5. En 8, el ECG de esfuerzo (Bruce) revelo desnivel negativo del ST mayor de 1 mm; en uno se efectuo estimulacion auricular con marcapaso, mostrando cambios inquemicos del ST. Las coronarias fueron angiograficamente normales en todos. En dos se presento espasmo coronario que fue reversible con nitroglicerina. El ventriculograma izquierdo fue normal en todos, excepto en uno que revelo hipocinesia diafragmatica asociada a espasmo de la coronaria derecha. Seguidos de dos a 56 meses (media de 19.4),el angor pectoris persistio igual solo en uno habiendo disminuido o desaparecido en el resto. En este lapso no hubo defunciones, infartos del miocardio ni arritmias graves