ABSTRACT
A Angina de Prinzmetal foi descrita em 1959, sendo caracterizada por ataques recorrentes de dor precordial ao repouso associados à elevação transitória do segmento S-T. Documentamos o caso de um homem, 58 anos, tabagista, previamente livre de sintomas coronarianos, que foi admitido com dor retroesternal aguda. O eletrocardiograma mostrou elevação transitória do segmento S-T nas derivações V1 a V3, que retornou à linha de base após cessar a dor. O nível sérico das enzimas cardíacas estava normal. O ecocardiograma não apresentou alterações segmentares da contratilidade do ventrículo esquerdo e a coronariografia demonstrou obstrução severa no terço proximal da artéria descendente anterior e na artéria diagonal. Foi tratado com nitrato, diltiazem e angioplastia com stent e não apresentou novos sintomas. Foi confirmado o diagnóstico de espasmo coronariano. Cabe ressaltar a importância de se incluir a Angina de Prinzmetal no diagnóstico diferencial da Síndrome Coronariana Aguda para que novos casos sejam precocemente diagnosticados.
Prinzmetal's Angina was described in 1959. It is characterized by recurrent episodes of spontaneous chest pain associated with transient ST-segment elevation. We report herein a case of a 58 year-old previously healthy man, who was admitted with acute retrosternal pain. Smoking was the only risk factor for atherosclerotic disease. The electrocardiogram showed transient ST-segment elevations from V1 toV3 leads. The cardiac enzymes tested normal. The echocardiogram didn't exhibit any abnormality in the left ventricular contractility and the coronary angiography revealed severe occlusion in both proximal part of the left anterior descending artery and the diagonal artery. The patient received nitrate and diltiazen, and the coronary lesions were treated with balloon angioplasty plus stenting. The follow up was uneventful. The diagnosis of variant angina (Prinzmental's angina) was made. In conclusion, Prinzmetal's Angina should always be included in the differential diagnosis of Acute Coronary Syndrome, so that new cases can be early diagnosed and treated.
Subject(s)
Coronary Vasospasm , Angina Pectoris , Angina Pectoris, VariantABSTRACT
This study focuses on the geographic distribution of the snail of the genus Biomphalaria and evaluates its infectivity by Schistosoma mansoni in 5264 specimens collected in the municipality of Juiz de Fora, Minas Gerais, Brazil. Of the 31 locations studied, 6 were reservoirs, 11 rudimentary holding ponds, 7 irrigation ditches, 5 lakes, 1 ornamental pond, and 1 waterfall. Intermediate hosts were found only in the rudimentary ponds and ditches, which were 100 percent positive. Using morphological and molecular analysis techniques, B. tenagophila, B. peregrina, and B. straminea were identified. This is the first report of B. stramínea in the municipality, and evaluation of its infective potential revealed susceptibility of 25.4 percent. Although we did not find specimens of Biomphalaria infected by S. mansoni, the data obtained indicate the presence of intermediate hosts, especially in the irrigation ditches in Juiz de Fora, and their proximity to contaminated areas.