ABSTRACT
The subject of this lecture has been chosen in relation to the contribution that professor H. Alessandri made in the first half of this century, as an outstanding clinician in the professional, humanistic and ethical development of generations of physicians in this country. This lecture is divided in 3 sections: the first reviews the practice in cardiology in the 50's, a period of initiation of the present advances in the specialty, still dominated at that time by semiologic and clinical approach. The second part presents examples of the significant contributions made by newer technologies in the fields of echocardiography, nuclear medicine, electrophysiology and therapeutic procedures. Finally, an assessment is made of the needed balance between technology and clinical judgement, coupled with humanistic and ethical considerations in the management of patients
Subject(s)
Humans , Cardiology/trends , Cardiovascular Diseases/history , Medical Laboratory Science/trends , Technological Development/trends , Ethics, Medical/history , History of MedicineSubject(s)
Humans , Tachycardia, Supraventricular/physiopathology , Atrial Flutter/diagnosis , Atrial Flutter/therapy , Bradycardia , Cardiac Complexes, Premature/therapy , Atrial Fibrillation/diagnosis , Atrial Fibrillation/drug therapy , Pacemaker, Artificial , Tachycardia, Ectopic Atrial , Tachycardia, Sinus , Tachycardia, Paroxysmal/diagnosis , Tachycardia, Paroxysmal/drug therapy , Tachycardia, Paroxysmal/therapySubject(s)
Humans , Tachycardia, Ventricular/physiopathology , Cardiac Complexes, Premature/diagnosis , Cardiac Complexes, Premature/physiopathology , Cardiac Complexes, Premature/therapy , Atrial Fibrillation/diagnosis , Atrial Fibrillation/therapy , Tachycardia, Paroxysmal/diagnosis , Tachycardia, Paroxysmal/therapySubject(s)
Humans , Syncope/diagnosis , Syncope/classification , Syncope/physiopathology , Syncope/therapySubject(s)
Humans , Coronary Disease/physiopathology , Angina Pectoris, Variant , Angina Pectoris/diagnosis , Angina Pectoris/therapy , Angiography , Exercise Test/classification , Myocardial Infarction/diagnosis , Myocardial Infarction/physiopathology , Myocardial Infarction/therapy , Myocardial Ischemia , Myocardial Revascularization/methodsSubject(s)
Humans , Heart Defects, Congenital/physiopathology , Ductus Arteriosus/physiopathology , Eisenmenger Complex/diagnosis , Eisenmenger Complex/therapy , Pulmonary Valve Stenosis/diagnosis , Heart Septal Defects, Ventricular/diagnosis , Heart Septal Defects, Ventricular/physiopathology , Heart Septal Defects, Ventricular/therapySubject(s)
Humans , Male , Female , Adult , Middle Aged , Myocardial Infarction/rehabilitation , Electrocardiography , Heart Function Tests/methods , Prospective Studies , PrognosisABSTRACT
Trienta y dos pacientes con hallazgos clínicos y patológicos de Lupus Eritematoso Sistémico (LES) fueron identificados en una revisión de necropsias en un período de veinte años en el Hospital del Salvador. Veintiséis pacientes (81,3%) tuvieron manifestaciones anatomopatológicas de compromiso cardiovascular (CV), ya que fuera directo o mediante hipertensión arterial. Solamente en 5 casos se hizo el diagnóstico clínico de compromiso CV directo (con insuficiencia valvular, insuficiencia cardiaca o pericarditis). En la necropsia se encontraron 13 casos de pericarditis (43,8%), 4 casos de miocarditis(12,5%), 4 casos de endocarditis verrucosa de Libman-Sacks (12,5%) de la válvula mitral y 1 caso de fibrosis endomiocárdica. No se hallaron pacientes con arteritis coronaria, aunque 11 tenían un grado discreto de ateroesclerosis. En 15 pacientes se hizo el diagnóstico clínico de hipertensión arterial (46,8%), mientras en 30 (93,75%) hubo hallazgos patológicos de nefritis lúpica. A pesar de la alta incidencia de hallazgos patológicos, la insuficiencia cardiaca clínica fue rara, documentándose solamente en 3 casos de esta serie (9,3%). La utilización rutinaria en la actualidad de exámenes no invasivos (especialmente ecocardiografía) debería facilitar el reconocimiento y ayudar al manejo del compromiso CV en el LES