ABSTRACT
El lupus eritematoso sistémico es una enfermedad autoinmune inflamatoria capaz de afectar cualquier aparato y sistema. Aunque la pericarditis es la manifestación cardíaca más frecuentemente observada, usualmente no es una situación que comprometa la vida del paciente. El taponamiento cardíaco ocasionado por derrame pericárdico en el lupus es una situación extremadamente rara, con una incidencia no mayor al 2%. Informamos el caso de una mujer de 21 años de edad con taponamiento cardíaco por lupus eritematoso sistémico, asociado a glomerulonefritis rápidamente progresiva, pancreatitis aguda, colecistitis aguda acalculosa, derrame pleural y actividad lúpica hematológica, cutánea y neurológica. El reconocimiento oportuno de esta rara manifestación del lupus puede salvar la vida de un paciente.
Systemic lupus erythematosus is a chronic inflammatory autoimmune disorder that can affect any organ or system. Although pericarditis is the most frequent cardiac manifestation of this entity, usually is not a life threatening situation. Pericardial effusion causing cardiac tamponade is a very rare complication in lupus, with an incidence less than 2%. We report a case of pericardial tamponade due to SLE with severe hemodynamic involvement in a 21-year-old woman associated to rapidly progressive glomerulonephritis, acute pancreatitis, acute acalculous cholecystitis, pleural effusion, hematologic, cutaneous and neurologic lupus activity. Recognition of this rare manifestation of SLE may be life saving.
Subject(s)
Adult , Female , Humans , Cardiac Tamponade/complications , Hemorrhage/diagnosis , Hemorrhage/etiology , Lupus Erythematosus, Systemic/complications , Pericardial Effusion/diagnosis , Pericardial Effusion/etiology , Pericarditis/diagnosis , Pericarditis/etiologyABSTRACT
En la actualidad, las indicaciones y alcances de la cardiología intervencionista permiten que cada vezmás pacientes puedan ser revascularizados mediante intervenciones coronarias percutáneas. Es esencial para los médicos que están en contacto o tienen a su cargo el cuidado de estos pacientes conocer los beneficios, características y riesgos del procedimiento. En este trabajo revisamos los conceptos generales actuales de la angioplastía coronaria.
At present, new indications and frontiers of interventional cardiology led to percutaneous treatment of a wide spectrum of patients who require myocardial revascularization. The physician must understand the potential benefits, procedural characteristics, andrisks of percutaneous coronary intervention. In this paper, we review general concepts concerning coronary angioplasty.
Subject(s)
Humans , Angioplasty, Balloon, Coronary , Coronary Disease/surgery , Angioplasty, Balloon, Coronary/adverse effects , Angioplasty, Balloon, Coronary/instrumentation , Drug Delivery Systems , Equipment Design , Postoperative Complications/prevention & control , StentsABSTRACT
Background. Patients with syncope show different responses to head-up tilt (HUT) test, which may be due to different pathophysiological mechanisms. Methods. HUT (70º) was perfumed in 24 patients who experienced recurrent syncope. Nine patients had a cardioinhibitory (CI) response, 7 patients had a vasodepressor (VD) response, and 8 patients had a mixed (MX) response. Heart rate variability was analysed at 60-sec periods during HUT: Results. Total spectrum (TS) was greater at rest and 1 min after syncope in the CI and MX groups as compared to the VD group. Low frequency spectrum (LF) was significantly greater during rest and the first minute after syncope in the CI groups as compared with the VD group. After the rest period, the CI and MX groups showed more elevated high frequency spectrum (HF) values than the VD group (p <0.01). One minute after syncope, the HF increased in the CI and MX groups but not in the VD group (p < 0.01). The VD group showed higher LF/HF ratio from the beginning of rest (3.9 ñ 4.1) as compared to the CI and MX groups (p <0.01). This differnce was most significant 2 min before syncope occurred. The CI and MX groups showed greater pNN50 and rMSSD as compared to the VD group. Conclusions. Our results suggest that vagal tone is higher in subjects showing cardioinhibitory and mixed responses to HUT. In contrast, patients with a vasodepressor response showed predominanty sympathetic activity. These findings suggest that there are differ ent pathophysiological mechanisms underlyng syncope