Burden of hemorrhagic stroke and hypertensive heart disease attributed to alcohol consumption in China / 中华流行病学杂志

Objective: To describe the prevalence of alcohol consumption and the burden of hemorrhagic stroke and hypertensive heart disease attributed to alcohol consumption in adults aged ≥20 years in 31 provinces in China from 2005 to 2018. Methods: Data from several national representative surveys was used to estimate provincial alcohol exposure level of adults aged ≥20 years from 2005 to 2018 by using kriging interpolation and locally weighted regression methods. Global disease burden research method and data, and China's death cause surveillance data were used to calculate the population attributable fraction (PAF) of hemorrhagic stroke and hypertensive heart disease and the deaths due to alcohol consumption in men and women aged ≥20 years in 31 provinces in China. China census data of 2010 were used to calculate the attributable standardized mortality rate. Results: In 2005 and 2018, the prevalence of alcohol consumption was 58.7% (95%CI: 57.8%-59.5%) and 58.4% (95%CI: 57.6%-59.3%), respectively, in men and 17.0% (95%CI: 16.6%-17.4%) and 18.7% (95%CI:18.1%-19.3%), respectively, in women. The daily alcohol intake was 24.6 (95%CI: 23.8-25.3) g and 27.7 (95%CI: 26.8-28.7) g, respectively, in men and 6.3 (95%CI: 6.0-6.5) g and 5.3 (95%CI: 5.0-5.6) g, respectively, in women. Alcohol exposure level was higher in the provinces in central and eastern China than in western provinces. The lowest exposure level was found in northwestern provinces. From 2005 to 2018, the PAF of hemorrhagic stroke death due to alcohol consumption increased from 5.5% to 6.8%, the attributable deaths increased from 50 200 to 59 100, while the PAF of hypertensive heart disease death due to alcohol consumption increased from 7.0% to 7.7%, the attributable deaths increased from 15 200 to 29 300. The PAF of hypertensive heart disease and hemorrhagic stroke was higher in men than in women, and in central and eastern provinces than in western provinces. In 2018, the standardized mortality rates of hemorrhagic stroke and hypertensive heart disease attributed to alcohol consumption were 4.58/100 000 and 2.11/100 000, respectively. Conclusions: The prevalence of alcohol consumption in men and daily alcohol intake of drinkers were relatively high in China, especially in eastern provinces. Alcohol exposure level was lower in women than in men. Regional measures should be taken to reduce the alcohol intakes in men and current drinkers in order to reduce the health problems caused by alcohol consumption.

Baja incidencia de cardiopatía clínicamente significativa en niños en edad escolar tras padecer COVID-19 / The low incidence of clinically significant heart disease in school-age children following COVID-19

No es clara la carga de morbimortalidad de la lesión cardíaca clínicamente evidente secundaria a la enfermedad por coronavirus de 2019 (COVID-19) en los niños en edad escolar. A lo largo de 12 meses, en un importante hospital pediátrico académico en la región del medio oeste de Estados Unidos, hubo 1481 casos de COVID-19 sin hospitalización en niños en edad escolar por lo demás sanos, en quienes se hicieron 195 pruebas cardíacas. Si bien aparecieron hallazgos fortuitos, no se descubrió ninguna patología cardíaca relacionada con la COVID-19. Además, ~3 % de los niños solamente tuvieron síntomas cardíacos agudos que requirieron una evaluación por el área de cardiología pediátrica. Los niños que no fueron hospitalizados por COVID-19 tienen un riesgo muy bajo de desarrollar daño cardíaco clínicamente significativo y son más propensos a presentar hallazgos fortuitos.

The burden of clinically-apparent cardiac injury secondary to coronavirus disease 2019 (COVID-19) in school-age children is unclear. Over 12 months at a large academic pediatric hospital in the Midwestern portion of the United States, there were 1481 COVID-19 positive non-hospitalized otherwise healthy schoolaged children with 195 having cardiac testing performed. While incidental findings occurred, no definitive COVID-19 related cardiac pathology was discovered. Additionally, only ~3 % of children had acute cardiac symptoms necessitating evaluation by pediatric cardiology. School-age children who were not hospitalized for COVID-19 have a very low risk of having clinically significant cardiac damage and are more likely to discover incidental findings.

Fatores de risco cardiovascular em funcionários de uma indústria de Alagoas / Cardiovascular risk factors in employees of a Alagoas industry

RESUMO: Introdução: As doenças cardiovasculares tornaram-se um grave problema de saúde pública no Brasil e compreendem uma das causas de afastamento do trabalho. Entretanto, sua ocorrência pode ser evitada se houver a identificação precoce de fatores de risco cardiovascular. Objetivo: Investigar a frequência de fatores de risco cardiovascular em funcionários de uma indústria de Alagoas e averiguar diferenças em sua ocorrência entre os setores de trabalho. Métodos: Trata-se de um estudo transversal analítico, realizado em fevereiro de 2019, com funcionários do setor administrativo e do setor operacional de uma indústria alagoana. Foram coletados dados sociodemográficos, antropométricos, clínicos e de estilo de vida. Consideraram-se como fatores de risco cardiovascular: pressão arterial alterada, indicadores antropométricos de risco cardiovascular, tabagismo, etilismo, sedentarismo e antecedentes pessoais ou familiares de doenças crônicas. A análise estatística foi realizada com auxílio do pacote estatístico R, usando o pacote Rcmdr. Para averiguar possíveis diferenças entre os fatores de risco em funcionários do setor administrativo e do setor operacional, realizou-se o teste t para amostras independentes, quando variáveis contínuas, e o teste do qui-quadrado de Pearson, quando categóricas, adotando-se nível de significância de 5%. Resultados: Foram avaliados 56 funcionários, com média de idade de 33 ± 8,5 anos. Destes, 80,4% eram do sexo masculino, 62,5% estavam com excesso de peso, 58,9% consumiam álcool, 53,6% realizavam alguma atividade física e 51,8% apresentavam antecedentes familiares cardiovasculares. Não houve diferença quanto à ocorrência desses fatores entre os setores de trabalho. Conclusão: Os fatores de risco cardiovascular mais frequentes foram excesso de peso, consumo de álcool e presença de antecedentes familiares, não tendo sido identificada diferença entre os trabalhadores do serviço operacional e administrativo. No entanto, a presença desses fatores é preocupante, principalmente por se tratar de amostra relativamente jovem (AU)

ABSTRACT: Introduction: Cardiovascular diseases are a serious public health problem in Brazil and comprise one of the causes of absence from work. However, its occurrence can be avoided if there is an early identification of cardiovascular risk factors. Objective: To investigate the frequency of cardiovascular risk factors in employees of an industry in Alagoas and to investigate differences in their occurrence between the sectors of work. Methods: This is an analytical cross-sectional, carried out in February 2019, with employees from the administrative sector and the operational sector of an industry in Alagoas. Sociodemographic, anthropometric, clinical and lifestyle data were collected. Altered blood pressure, anthropometric indicators of cardiovascular risk, smoking, alcohol consumption, physical inactivity and personal or family history of chronic diseases were considered as cardiovascular risk factors. The statistical analysis was performed with the statistical package R, using the package Rcmdr. In order to ascertain possible differences between risk factors in employees of the administrative sector and the operational sector, the t test for independent samples was performed, when continuous variables, and the Pearson chi-square test was performed, when categorical variables, adopting a level significance of 5%. Results: 56 employees were evaluated, with a mean age of 33 ± 8.5 years. Of these, 80.4% were male, 62.5% were overweight, 58.9% consumed alcohol, 53.6% performed some physical activity and 51.8% had a cardiovascular family history. There was no difference in the occurrence of these factors between the sectors of work. Conclusion: The most frequent cardiovascular risk factors were overweight, alcohol consumption and presence of family history, with no difference being identified between workers in the operational sector and the administrative sector. However, the presence of these factors is worrying, mainly because it is a relatively young sample (AU)

Metabolic Syndrome and Risk of Cardiovascular Diseases in Female Breast Cancer Survivors

Abstract Background The implementation of intensive therapy protocols increases the probability of adverse events in patients with breast cancer (BC). Components of metabolic syndrome (MS) are among these events. Objective To verify the prevalence of MS and cardiovascular disease (CVD) risk in female BC survivors. Materials and Methods This is a descriptive, observational, cross-sectional study. Our sample comprised 60 women without BC (G1) and 60 women who had survived BC (G2). We collected sociodemographic, anthropometric, tumor, and clinical data. After variable analysis, the participants received positive or negative MS diagnoses and a 10-year CVD risk stratification. The significance level adopted for the analyses was 5% ( p < 0.05) and the confidence interval (CI) was 95%. For comparing categorical data, we used the chi-squared, Fisher's exact, or G tests; for comparing continuous data, we used the parametric Student's t-test and the non-parametric Mann-Whitney test. Results Both groups presented overweight and an increased waist-to-hip ratio. Weight, body mass index, abdominal circumference, hip circumference, and low-density cholesterol were variables that presented statistically significant differences between groups. MS was diagnosed in 32% of women in G1 and 45% of those in G2. Regarding the 10-year risk for CVD, most women were in the low-risk stratum: the mean total risk of CVD occurrences was 7.48% in G1 and 7.70% in G2. Conclusion We observed a higher prevalence of MS among women who survived BC, possibly due to overweight, as well as a low 10-year risk for CVD after cancer treatment. Although we did not observe a statistically significant difference, we suggest the adoption of a healthy lifestyle and rigorous control of cardiometabolic risk factors.

The REBECGA brazilian registry of pregnancy and heart disease: rationale and design

BACKGROUND: Maternal mortality rates in Brazil remain above the goals established by the United Nations Sustainable Development Goals. Heart disease is estimated to affect 4% of all pregnancies and remains by itself the main indirect obstetric cause of maternal death. In the last decades, a significant improvement in the prognosis of heart diseases has made pregnancy possible in women with heart disease and provided better maternal and fetal outcomes. OBJECTIVES: To establish a multicenter Brazilian Registry of pregnant women with heart disease; to study the causes of immediate and late maternal mortality; and to assess the prevalence of heart disease in the country's macro-regions. METHODS: This is an observational study, with retrospective and prospective stages, of the clinical and obstetric progression of pregnant women with heart disease. These women consecutively received care during pregnancy and will be followed up for up to a year after delivery at public and private hospitals with infrastructure for the execution of this project, a principal investigator, and approval by Ethics and Research Committees. RESULTS: Our results will be presented after data collection and statistical analysis, aiming to demonstrate immediate and late maternal mortality rates, as well as the prevalence of heart disease in the country and its cardiovascular and obstetric complications during pregnancy. CONCLUSIONS: REBECGA will be the Brazilian Registry of heart disease and pregnancy and it will contribute to planning preventive measures, raising financial resources for the improvement of high-risk prenatal care, and reducing immediate and late maternal mortality due to heart disease.

Comportamiento de la cardiopatía isquémica en una unidad de cuidados intensivos / Characteristics of ischemic heart disease in an intensive care unit

Introducción: La cardiopatía isquémica es frecuente, tiene diversas formas de manifestarse y predomina entre las enfermedades que motivan el ingreso de pacientes a unidades de emergencias, y que causan ingresos hospitalarios. Objetivo: Profundizar en el conocimiento de los pacientes con cardiopatía isquémica en una unidad de cuidados intensivos municipal. Método: Se realizó un estudio descriptivo y transversal, de 528 pacientes que ingresaron en la Unidad de Cuidados Intensivos del Hospital General Docente Orlando Pantoja Tamayo, Contramaestre, Santiago de Cuba, con diagnóstico de cardiopatías isquémicas, desde enero de 2016 hasta junio de 2019. Las variables utilizadas fueron: grupo de edades, sexo, diagnostico al ingreso, antecedentes patológicos personales, estadía y estado al egreso. Se utilizó el porcentaje para resumir la información, así como el test chi cuadrado para identificar asociación estadística. Resultados: Hubo predominio del sexo masculino y edades entre 60-70 y 36-59 años, fueron más frecuentes el infarto agudo de miocardio y la combinación de 3 o más factores de riesgo. El mayor número de fallecimientos se ocurrió en los primeros 3 días de admitidos y en pacientes con ventilación mecánica invasiva. Conclusiones: El comportamiento de las enfermedades cardiovasculares continúa siendo un gran problema de salud, aparece en edades cada vez más tempranas. En casos severos la mortalidad puede ocurrir en las primeras 72 h(AU)

Introduction: Ischemic heart disease is frequent, has different manifestation forms, and predominates among diseases leading to patient admission into emergency units and hospital admissions in general. Objective: To deepen the knowledge of patients with ischemic heart disease in a municipal intensive care unit. Method: A descriptive and cross-sectional study was carried out of 528 patients who were admitted into the intensive care unit of Orlando Pantoja Tamayo General Teaching Hospital in Contramaestre Municipality, Santiago de Cuba, with a diagnosis of ischemic heart disease, from January 2016 to June of 2019. The variables used were age group, sex, diagnosis at admission, personal pathological history, hospital stay, and status at discharge. We used percentage to summarize the information, as well as the chi-square test to identify statistical association. Results: There was a predominance of males and ages between 60-70 and 36-59 years. Acute myocardial infarction and the combination of three or more risk factors were more frequent. The highest number of deaths occurred in the first three days after admission and among patients with invasive mechanical ventilation. Conclusions: The characteristics of cardiovascular diseases continues to be a major health concern, as long as they are appearing at increasingly earlier ages. In severe cases, mortality can occur in the first seventy-two hours(AU)

Fatores de risco para óbito por COVID-19 no Acre, 2020: coorte retrospectiva / Factores de riesgo de muerte por COVID-19, en Acre, Brasil, 2020: cohorte retrospectiva / Risk factors for death due to COVID-19, in the state of Acre, Brazil, 2020: a retrospective cohort study

Objetivo: Analisar fatores de risco para óbito em indivíduos com síndrome respiratória aguda grave por COVID-19. Métodos: Coorte retrospectiva, constituída de indivíduos adultos com COVID-19, de março a setembro de 2020, notificados pelo sistema de vigilância epidemiológica do estado do Acre, Brasil. Empregou-se regressão de Cox. Resultados: Entre 57.700 indivíduos analisados, a incidência foi de 2.765,4/100 mil habitantes, e a mortalidade, de 61,8/100 mil hab. Os fatores de risco para o óbito foram ser do sexo masculino (HR=1,48 - IC95% 1,25;1,76), ter idade ≥60 anos (HR=10,64 - IC95% 8,84;12,81), sintoma de dispneia (HR=4,20 - IC95% 3,44;5,12) e apresentar multimorbidade (HR=2,23 - IC95% 1,77;2,81), com destaque para cardiopatas e diabetes mellitus. Os sintomas 'dor de garganta' e 'cefaleia' estavam presentes nos casos leves da doença. Conclusão: Ser homem, idoso, apresentar cardiopatia, diabetes mellitus e dispneia foram características associadas ao óbito pela COVID-19.

Objetivo: Analizar los factores de riesgo de muerte en individuos con Síndrome Respiratorio Agudo Grave por COVID-19. Métodos: Cohorte retrospectiva, con individuos adultos con COVID-19, entre marzo y septiembre 2020, notificado pelo Sistema de Vigilancia Epidemiológica en el estado de Acre, Brasil. Se utilizó la regresión de Cox. Resultados: 57.700 individuos evaluados, la incidencia fue de 2.765,4/100.000 habitantes y la mortalidad 61,8/100.000 habitantes. Los factores de riesgo de muerte fueron: sexo masculino (HR=1,48 - IC95% 1,25;1,76), edad ≥60 años (HR=10,64 - IC95% 8,84;12,81), disnea (HR=4,20 - IC95% 3,44;5,12), multimorbidad (HR=2,23 - IC95% 1,77;2,81), incluidos problemas cardíacos y diabetes. Los síntomas dolor de garganta y de cabeza estuvieron presentes en casos leves de la enfermedad. Conclusión: Hombres, ancianos, personas com enfermedades cardíacas, diabetes y disnea fueron características asociadas com la muerte por COVID-19.

Objective: To analyze risk factors for death in individuals with severe acute respiratory syndrome due to COVID-19. Methods: This was a retrospective cohort study, comprised of adult individuals with COVID-19, from March to September 2020, notified by the Epidemiological Surveillance System in the state of Acre, Brazil. Cox regression was used. Results: Among 57,700 individuals analyzed, the incidence was 2,765.4/100,000 inhabitants, and mortality was, 61.8/100,000 inhabitants. The risk factors for death were: being male (HR=1.48 -95% CI 1.25;1.76), age ≥60 years (HR=10.64 -95% CI 8.84;12.81), symptom of dyspnea (HR=4.20 -95% CI 3.44;5.12) and multimorbidity (HR=2.23 -95% CI 1.77;2.81), with emphasis on heart disease and diabetes mellitus. 'Sore throat' and 'headache' were symptoms present in mild cases of COVID-19. Conclusion: Being male, elderly, having heart disease, diabetes mellitus and dyspnea were characteristics associated with death due to COVID-19.

Caracterização de pacientes cardiopatas em uma unidade de dor torácica: perfil de chegada / Characterization of cardiopathy patients in a thoracic pain unit: arrival profile / Caracterización de pacientes cardiopatas en una unidad de dolor torácico: perfil de llegada

Objetivo: Caracterizar os usuários cardiopatas que acessam a Unidade de Dor Torácica (UDT) de um hospital geral no norte do Estado do Rio Grande do Sul. Métodos: Estudo transversal, descritivo, de abordagem quantitativa, que foi realizado na UDT do Hospital da Cidade de Passo Fundo, abordando pacientes com suspeita ou com diagnóstico médico de Doença Cardiovascular (DCV). Resultados: Coleta dos dados realizada com 112 pacientes. Houve o predomínio de idosos, homens com baixas condições socioeconômicas e alta incidência de diagnóstico de Síndrome Coronariana Aguda (SCA) sendo que a dor torácica esteve presente em grande parte dos pacientes. Conclusões: Conhecer a população que acessou a UDT possibilitou reflexões acerca da temática, bem como a importância do referido serviço, no qual serve como porta de entrada para pacientes em condições agudas e crônicas de DCV

Objective: To characterize the cardiac patients who access the Thoracic Pain Unit (UDT) of a general hospital in the north of the State of Rio Grande do Sul. Methods: a cross-sectional, descriptive, quantitative study was carried out at the UDT of the Hospital of the City of Passo Fundo, addressing patients with suspicion or medical diagnosis of Cardiovascular Disease (CVD). Results: Data collection with 112 patients.There was a predominance of elderly, men with low socioeconomic conditions and a high incidence of acute coronary syndrome (ACS), and chest pain was present in most patients. Conclusions: Knowing the population that accessed the UDT made possible reflections on the subject, as well as the importance of this service, which serves as a gateway for patients in acute and chronic conditions of CVD

Objetivo: Caracterizar a los usuarios cardiopatas que accede a la Unidad de Dolor Torácica (UDT) de un hospital general en el norte del Estado de Rio Grande do Sul. Métodos: estudio transversal, descriptivo, de abordaje cuantitativo, que fue realizado en la UDT del Hospital de la Ciudad de Passo Fundo, abordando pacientes con sospechosos o con diagnóstico médico de Enfermedad Cardiovascular (ECV). Resultados: Recolección de los datos realizada con 112 pacientes.Hubo el predominio de ancianos, hombres con bajas condiciones socioeconómicas y alta incidencia de diagnóstico de Síndrome Coronaria Aguda (SCA), siendo que el dolor torácico estuvo presente en gran parte de los pacientes. Conclusiones: Conocer la población que accedió a la UDT posibilitó reflexiones acerca de la temática, así como la importancia de dicho servicio, en el cual sirve como puerta de entrada para pacientes en condiciones agudas y crónicas de ECV

Risk factors for cardiac, obstetric, and neonatal complications in patients with heart disease during pregnancy / Factores de riesgo para complicaciones cardíacas, obstétricas y neonatales en pacientes con enfermedad cardíaca durante el embarazo

Abstract Objective: Heart disease in pregnancy can cause clinical deterioration and maternal-fetal death. It is essential to evaluate risk factors related to complications. Methodology: This was a observational, analytical retrospective cohort study with a non-probabilistic convenience sample of pregnant women with congenital or acquired heart disease, corrected or not, or arrhythmias requiring urgent intervention. Patients with mild or moderate valvular regurgitation, mild valvular stenosis, patients without echocardiography or without delivery information were excluded from the study. The outcome was a composite of cardiac, obstetric, and neonatal events. Univariate and multivariate analyzes were performed with logistic regression model and discriminatory capacity with area under the curve and independent analysis of the modified World Health Organization (mWHO) risk classification (mWHO). Results: A total of 104 patients with an average age of 25 ± 6.5 years presented cardiac events in 13.5%, obstetric in 14.42%, and neonatal in 28.85%. The univariate analysis found an association with New York Heart Association functional status, hypertensive disorders of pregnancy, cesarean delivery, gestational age < 27 weeks, hypoxemia, and mWHO risk. In multivariate only cesarean delivery (odds ratio [OR], 2.68; 95% confidence interval [CI], 1.05-6.86) and gestational age at delivery (OR, 0.39; 95% CI, 0.22-0.67) maintain association with outcomes. The area under the curve for the mWHO risk is 0.75. Conclusions: There is a high rate of adverse events in patients with heart disease during pregnancy. Gestational age and cesarean delivery behaved as predictors of adverse maternal-fetal outcomes. The mWHO risk classification had an acceptable prediction of adverse outcomes.

Resumen Objetivo: La enfermedad cardíaca en el embarazo puede ocasionar deterioro clínico y muerte maternofetal. Es indispensable evaluar factores de riesgo relacionados con complicaciones. Método: Estudio observacional y analítico de cohorte retrospectivo con muestra no probabilística por conveniencia de embarazadas con cardiopatía congénita o adquirida, corregida o no, o arritmias que requerían intervención urgente. Se excluyó a pacientes con insuficiencias valvulares leves o moderadas, estenosis valvulares leves, pacientes sin ecocardiografía o sin información del parto. El desenlace fue un compuesto de episodios cardíacos, obstétricos y neonatales. Se realizó análisis univariado y multivariado con modelo de regresión logística y capacidad diferenciadora con área bajo la curva y análisis independiente de la clasificación de riesgo de la OMS modificada (OMSm). Resultados: 104 pacientes con edad promedio de 25 ± 6.5 años presentaron episodios cardíacos en 13.5%, obstétricos en 14.42% y neonatales en 28.85%. El análisis univariado encontró una relación con el estado funcional de la NYHA, trastornos hipertensivos del embarazo, parto por cesárea, edad gestacional < 27 semanas, hipoxemia y riesgo de la OMSm. En el multivariado sólo el parto por cesárea (OR, 2.68; IC 95%, 1.05-6.86) y la edad gestacional al momento del parto (OR, 0.39; IC 95%, 0.22-0.67) mantienen nexo con los desenlaces. El área bajo la curva para el riesgo de la OMSm es de 0.75. Conclusiones: Hay una elevada tasa de efectos adversos en pacientes con enfermedad cardíaca durante el embarazo. La edad gestacional y el parto por cesárea se comportaron como predictores de resultados adversos maternofetales. La clasificación de riesgo de la OMSm tuvo una predicción aceptable de desenlaces adversos.

Descrição dos casos hospitalizados pela COVID-19 em profissionais de saúde nas primeiras nove semanas da pandemia, Brasil, 2020 / Descripción de los casos hospitalizados por COVID-19 en profesionales de salud en las primeras nueve semanas de la pandemia, Brasil, 2020 / Description of COVID-19 hospitalized health worker cases in the first nine weeks of the pandemic, Brazil, 2020

Objetivo: Descrever os casos hospitalizados pela COVID-19 em profissionais de saúde no Brasil. Métodos: Estudo descritivo de tipo série de casos; foram incluídos aqueles com adoecimento entre 21 de fevereiro e 15 de abril de 2020, registrados no Sistema de Informação de Vigilância da Gripe (SIVEP-Gripe). Resultados: Dos 184 casos, 110 (59,8%) eram do sexo feminino, com mediana de idade de 44 anos (mínima-máxima: 23-85); 89 (48,4%) eram profissionais da enfermagem e 50 (27,2%) eram médicos. Ainda, 92 (50,0%) apresentavam comorbidade, predominando cardiopatias (n=37; 40,2%). Dos 112 profissionais com registro de evolução, 85 (75,9%) alcançaram cura e 27 (24,1%) foram a óbito, 18 destes do sexo masculino. Conclusão: O perfil dos profissionais de saúde hospitalizados por COVID-19 é semelhante ao da população quanto à idade e comorbidades; porém, diferente quanto ao sexo. As áreas profissionais mais acometidas foram a enfermagem e a medicina.

Objetivo: Describir los casos hospitalizados por COVID-19 en profesionales de salud, en Brasil. Métodos: Estudio descriptivo del tipo serie de casos; se incluyeron aquellos que enfermaron entre el 21 de febrero y el 15 de abril de 2020, registrados en el Sistema de Información de Vigilancia de la Gripe (SIVEP-Gripe). Resultados: De los 184 (1,76%) casos 110 (59,8%) eran del sexo femenino, con promedio de edad de 44 años (mínima-máxima: 23-85), 89 (48,4%) eran profesionales de enfermería y 50 (27,2%) médicos. Además, 92 (50,0%) presentaron comorbilidad, predominando las cardiopatías (n=37; 40,2%). De los 112 profesionales con un historial de evolución, 85 (75,9%) fueron curados y 27 (24,1%) murieron, 18 de los cuales era de sexo masculino. Conclusión: El perfil de los hospitalizados por COVID-19 es similar al de la población en edad y comorbilidades, aunque diferente con relación a sexo. Las áreas más afectadas fueron la enfermería y la medicina.

Objective: To describe COVID-19 hospitalized health worker cases in Brazil. Methods: This was a descriptive case series study; it included cases that became ill between February 21st and April 15th, 2020 registered on the Influenza Surveillance Information System (SIVEP-Gripe, acronym in Portuguese). Results: Of the 184 cases, 110 (59.8%) were female and median age was 44 years (min-max: 23-85); 89 (48.4%) were nursing professionals and 50 (27.2%) were doctors. Ninety-two (50.0%) presented comorbidity, with heart disease predominating (n=37; 40.2%). Of the 112 professionals with a record of case progression, 85 (75.9%) were cured and 27 (24.1%) died, 18 of whom were male. Conclusion: The profile of COVID-19 hospitalized health workers is similar to that of the general population with regard to age and comorbidities, but different in relation to sex. The most affected areas were nursing and medicine.

Hiponatremia em pacientes internados / Hyponatremia in hospitalized patients

Objetivo: Avaliar a prevalência de hiponatremia em pacientes internados, determinando seu perfil epidemiológico. Métodos: Estudo prospectivo, observacional e longitudinal. Utilizou-se o banco de dados do hospital no período entre março e maio de 2017, com total de 320 indivíduos. A análise estatística foi rea- lizada por meio do Statistical Package for Social Science, versão 24.0. Resultados: Do total de 320 pacientes avaliados, 51,6% deles eram do sexo masculino. A idade média foi de 62,73 anos, e a maior parte era da cor parda. Desenvolveram hiponatremia no decorrer do estudo 135 (42,18%) pacientes. Diabéticos tiveram maior predisposição a desenvolver hiponatremia (57,7%). Outras comorbidades também foram frequentes, como hipertensão ar- terial sistêmica (61,9%) e doenças neurodegenerativas (23,3%). Conclusão: Houve maior prevalência de hiponatremia nos pa- cientes do sexo feminino, acima dos 60 anos e pardos. O diabetes mellitus foi considerado fator de risco para o desenvolvimento da hiponatremia. Os resultados visam ampliar a percepção a respeito desse distúrbio hidroeletrolítico tão encontrado na clínica médica e que, muitas vezes, não recebe a devida importância.

Objective: to evaluate the prevalence of hyponatremia in hos- pitalized patients, determining their epidemiological profile. Me- thods: This is a prospective, observational and longitudinal study. The hospital database was used from March to May 2017, with a total of 320 individuals. The statistical analysis was done by means of the Statistical Package for Social Science, version 24.0. Results: Of the 320 patients evaluated, 51.6% were male. The mean age was 62.73 years old, with most of them being brown-skinned. A total of 135 (42.18%) of the patients developed hyponatremia over the course of the study. Diabetics had greater predisposition to de- velop hyponatremia (57.7%). Other frequent comorbidities were systemic arterial hypertension (61.9%) and neurodegenerative diseases (23.3%). Conclusion: There was a higher prevalence in females, those above 60 years old, and brown-skinned. Diabetes mellitus was considered a risk factor for the development of hypo- natremia. The results aim to increase the perception regarding this hydroelectrolytic disorder frequently found in internal medi- cine practice, and that does not receive the proper importance.

H1N1: perfil clínico-epidemiológico de pacientes atendidos em um hospital / H1N1: clinical and epidemiological profile of patients treated in a hospital

Objetivo: Avaliar casos de suspeita de gripe H1N1, bem como comparar aspectos epidemiológicos e clínicos dos pacientes com gripe H1N1 confirmada em relação àqueles não confirmados; analisar os critérios de gravidade clínica com relação à confirmação (ou não) da gripe H1N1 e seu desfecho (mortalidade); e criar um banco de dados para fins de comparação com a literatura nacional e mundial. Métodos: Estudo retrospectivo de coorte transversal realizado no período sazonal (outono e inverno) no ano de 2016. Foram analisados os prontuários, acessíveis e completos, de pacientes com suspeita clínica de H1N1, além daqueles com resultados definidos na sorologia. A partir dos dados coletados, foi elaborada tabela de análise epidemiológica, com informações clínicas, laboratoriais e sorológicas. Resultados: Destacam-se a média das faixas etárias mais acometidas de 48 anos, além dos sintomas mais comuns que foram dispneia, tosse e mialgia; as comorbidades foram hipertensão arterial sistêmica, cardiopatias, diabetes e doença pulmonar obstrutiva crônica. Conclusão: Este trabalho contribuiu com a caracterização do perfil epidemiológico regional e auxiliou na definição de indicadores de diagnóstico e gravidade, além de agregar à literatura conteúdos de caráter relevante. Este estudo está registrado como CAAE 58664016.2.0000.5515 na Plataforma Brasil. (AU)

Objective: To evaluate cases of suspected H1N1 flu, as well as to compare epidemiological and clinical aspects of patients with confirmed H1N1 influenza to those who were not confirmed; to analyze the criteria of clinical severity regarding the confirmation (or not) of H1N1 influenza, and its outcome (mortality); and to create a database to be compared with the national and world literature. Methods: This is a cross-sectional retrospective cohort study, carried out in the seasonal period ( fall/winter) of 2016. Accessible and complete medical records of patients with clinical suspicion of H1N1 were analyzed along with those with defined serology results. Based on the collected data, a table of epidemiological analysis was elaborated with clinical, laboratory and serological information. Results: The mean age of the most affected age groups was 48 years; the most common symptoms were dyspnea, cough and myalgia; and the comorbidities were systemic arterial hypertension, cardiopathies, diabetes, and chronic obstructive pulmonary disease. Conclusion: This work contributed to the characterization of the regional epidemiological profile, and helped in the definition of indicators of diagnosis and severity, besides adding relevant content to the literature. This study is registered as CAAE 58664016.2.0000.5515 at Plataforma Brasil. (AU)

Consultorio de orientaciòn de cardilogía: epidemiología y perfil de la población / Cardiology guidance clinic: Epidemiology and profile of the population

Introducción: Las cardiopatías congénitas (CC) son las anomalías congénitas más frecuentes. Representan el 0,8-1,2% de todos los defectos del nacimiento y tienen una prevalencia de alrededor de 5,8 por cada 1000 personas. El Servicio de Cardiología del Hospital Garrahan es un centro de referencia nacional y de países limítrofes donde se realizan 18000 consultas anuales. Los pacientes que concurren por primera vez se atienden en el consultorio de orientación. Objetivo: Describir la epidemiologia y perfil de los pacientes que asisten diariamente al consultorio de orientación de cardiología infantil en un hospital pediátrico de tercer nivel de Buenos Aires. Métodos: Entre septiembre de 2017 y febrero de 2018 se recolectaron los datos de 1000 pacientes atendidos en forma consecutiva en el consultorio de orientación de cardiología. A la totalidad de los pacientes se les realizó anamnesis, examen físico cardiovascular, electrocardiograma, y en los casos en los que se consideró necesario, saturometría, radiografía de tórax y/o ecocardiograma. Las variables a considerar fueron edad, procedencia, presencia o ausencia de cardiopatías congénitas o adquiridas, soplo, cianosis, insuficiencia cardíaca, estado nutricional, síndromes genéticos asociados, métodos diagnósticos e indicaciones terapéuticas implementadas. Se subdividió la población en cinco grupos: Grupo A (pacientes con cardiopatía congénita), Grupo B (cardiopatías operadas), Grupo C (miocardiopatías), Grupo D (arritmias), Grupo E (corazón sano). Resultados: La edad mediana fue 4.86 años (0.03 a 18.9 años). El 64% de los pacientes procedían de la provincia de Buenos Aires. Los motivos de consulta fueron: interconsultas internas 29.5%, derivación por cardiopatía 27.2%, soplo 17.6%, síncope 7%, segunda opinión 5.1%, arritmias 4.8%, precordialgia 3.1%, palpitaciones 2.6%, episodio paroxístico 1.4%, cardiomegalia 0.7%, disnea 0.5%, mal progreso de peso 0.3%. El 10.6% tenían un síndrome genético. Grupo A: 252 pacientes con una edad mediana de 1.9 años. Las cardiopatías acianóticas con hiperflujo pulmonar fueron las más frecuentes (66.66%, 168/252). Grupo B: 51 pacientes, 23.52%(12/51) fueron Fallot reparados en otra institución. Grupo C: 22 pacientes, siendo la miocardiopatía hipertrófica la más frecuente. Grupo D: 47 pacientes, la preexcitación ventricular fue el hallazgo más frecuente (34,04%, 16/47). Grupo E: 628 pacientes, 45.70% (287/628) derivados por pediatras del área ambulatoria, principalmente para valoración de pacientes con enfermedades sistémicas o síndromes genéticos. Conclusión: Los motivos de derivación al consultorio de orientación de cardiología fueron muy diversos. La mayoría de los pacientes provenían de provincia de Buenos Aires. Solamente el 37.2% presentó algún problema cardiológico de base. El 91% de los pacientes que consultaron por soplo, no tuvieron cardiopatía. El grupo correspondiente a los pacientes con cardiopatías no operadas (grupo A) fue el de menor edad (mediana de 1.9 años) y las cardiopatías simples no cianóticas con hiperflujo pulmonar representaron el 66.66% de las cardiopatías. La implementación del ecocardiograma portátil en el consultorio de orientación permitió confirmar el diagnóstico y definir la conducta terapéutica en el 29.4% de los pacientes durante la primer consulta (AU)

Introduction: Congenital heart defects (CHD) are the most common congenital abnormalities. They account for 0.8-1.2% of all birth defects and have a prevalence of around 5.8 per 1000 people. The Department of Cardiology of Garrahan Hospital is a national and bordering-country reference center, receiving 18000 consultations annually. Patients seen for the first time are assessed at the cardiology guidance clinic. Objective: To describe the epidemiology and profile of patients who seen daily at the child cardiology guidance clinic of a third-level pediatric hospital in Buenos Aires. Methods: Between September 2017 and February 2018, data from 1000 patients consecutively seen at the cardiology guidance clinic were collected. All patients underwent anamnesis, cardiovascular physical examination, electrocardiogram and, if considered necessary, pulse oximetry, chest x-ray, and/or echocardiogram. The variables considered were age, place of origin, presence or absence of congenital or acquired heart disease, murmur, cyanosis, heart failure, nutritional status, associated genetic syndromes, diagnostic methods, and treatment. The population was divided into five groups: Group A (patients with congenital heart defects), Group B (operated cardiopathies), Group C (myocardiopathies), Group D (arrhythmias), Group E (healthy heart). Results: Median age was 4.86 years (0.03 to 18.9 years). Overall, 64% of patients came from the province of Buenos Aires. The reasons for consultation were: internal consultations 29.5%, cardiac shunt 27.2%, murmur 17.6%, syncope 7%, second opinion 5.1%, arrhythmias 4.8%, precordialgia 3.1%, palpitations 2.6%, paroxysmal episode 1.4%, cardiomegaly 0.7%, dyspnea 0.5%, 0.3% poor weight gain. A genetic syndrome was identified in 10.6%. Group A: 252 patients with a median age of 1.9 years. Acyanotic congenital heart defect with pulmonary hyperflow was the most common (66.66%, 168/252). Group B: 51 patients, 23.52% (12/51) had tetralogy of Fallot repaired at another institution. Group C: 22 patients, in whom hypertrophic cardiomyopathy was the most common. Group D: 47 patients, in whom ventricular preexcitation was the most common finding (34.04%, 16/47). Group E: 628 patients, 45.70% (287/628) referred by pediatricians from the outpatient clinics, mainly for the assessment of systemic diseases or genetic syndromes. Conclusion: The reasons for referral to the cardiology guidance clinic were varied. Most of the patients came from the province of Buenos Aires. Only 37.2% had an underlying heart disease. Of the patients who consulted because of a murmur, 91% did not suffer from heart disease. The group of patients with congenital heart disease who had not undergone surgery (group A) was the youngest (median 1.9 years) and simple non-cyanotic heart disease with pulmonary hyperflow accounted for 66.66% of heart diseases. The implementation of the portable echocardiography in the guidance clinic confirmed the diagnosis and defined the management in 29.4% of patients during the first consultation (AU)

Enfermedad vascular en pacientes varones con enfermedad de Fabry en hemodiálisis: estudio de cohorte retrospectivo en Argentina / Vascular disease in male patients with Fabry disease on hemodialysis: a retrospective cohort study in Argentina

Introducción: Los eventos vasculares (EV) tanto cardiovasculares (ECV) como cerebrovasculares (ACV) son la principal causa de muerte en pacientes con enfermedad de Fabry (EF). El objetivo de este estudio fue describir la aparición de EV en pacientes con EF y enfermedad renal crónica terminal (ERCT) en hemodiálisis durante el seguimiento. Material y métodos: Estudio de cohorte retrospectivo realizado en tres centros de Argentina entre enero de 2010 y enero de 2017. Se incluyeron pacientes con EF y ERT en hemodiálisis. Se recopiló información sobre aspectos demográficos, clínicos y EV. Resultados: Se incluyeron ocho pacientes varones adultos (40 ± 4.2 años) con ERCT en hemodiálisis (tiempo medio en diálisis 39.1 ± 20.6 meses), con un tiempo medio de seguimiento de 55 ± 12 meses. Cinco pacientes recibieron terapia de reemplazo enzimático durante el seguimiento. Cuatro pacientes (50%) tuvieron EV durante el seguimiento. En tres de ellos el evento cardiovascular fue fatal. El tiempo medio desde el ingreso a diálisis hasta la aparición del EV fue de 38 ± 8 meses. Conclusión: 50% de los pacientes con EF y ERCT presentaron un EV en un tiempo medio de 38 meses aproximadamente desde su ingreso en diálisis

Introduction: Vascular events (VE), both cardiovascular (CVD) and cerebrovascular (CVA), are the main cause of death in patients with Fabry disease (FD). The aim of this study was to describe the occurrence of VE in patients with FD and end-stage renal disease (ESRD) on hemodialysis during follow-up. Methods: a retrospective, cohort study was carried out at three centers in Argentina between January 2010 and January 2017. Hemodialysis patients with FD and ESRD were included. Information was collected regarding demographic, clinical and VE aspects. Results: Eight adult (40 ± 4.2 year-old) male patients with ESRD on hemodialysis (mean time on dialysis: 39.1 ± 20.6 months) were included; the mean follow-up time was 55 ± 12 months. Five patients received enzyme replacement therapy during follow-up. Four patients (50%) had VE during follow-up. In three of them the cardiovascular event was fatal. The mean time from admission to dialysis until the onset of VE was 38 ± 8 months. Conclusion: 50% of the patients with FD and ESRD presented a VE in a mean time of approximately 38 months since their admission to dialysis

Diagnóstico médico autorreferido de doença cardíaca e fatores de risco associados: Pesquisa Nacional de Saúde / Self-reported medical diagnosis of heart disease and associated risk factors: National Health Survey

RESUMO: Objetivo: Analisar os fatores de risco associados ao diagnóstico médico autorreferido de doença cardíaca no Brasil. Métodos: Trata-se de um estudo transversal que analisa informações da Pesquisa Nacional de Saúde (PNS), realizada em 2013. A amostra consistiu de 60.202 adultos. A doença cardíaca foi definida pelo diagnóstico médico autorreferido de doença do coração. Foram analisadas associações entre a ocorrência de doença e as características sociodemográficas, as condições de saúde e o estilo de vida. Foi empregado o modelo de regressão logística binária hierarquizado. Resultados: A prevalência de diagnóstico autorreferido de doença cardíaca no Brasil foi de 4,2% (intervalo de confiança de 95% [IC95%] 4,0 ‒ 4,3) e esteve associada a sexo feminino (odds ratio [OR] = 1,1; IC95% 1,1 ‒ 1,1), idade igual ou maior que 65 anos (OR = 4,7; IC95% 3,3 ‒ 5,6), avaliação do estado de saúde ruim/muito ruim (OR = 4,1; IC95% 3,5 ‒ 4,6) e regular (OR = 2,4; IC95% 2,2 ‒ 2,7), indivíduos hipertensos (OR = 2,4; IC95% 2,2 ‒ 2,7), colesterol elevado (OR = 1,6; IC95% 1,5 ‒ 1,8), sobrepeso (OR = 1,5; IC95% 1,4 ‒ 1,8) e obesidade (OR = 2,0; IC95% 1,7 ‒ 2,2), insuficientemente ativo nos quatro domínios (OR = 1,5; IC95% 1,02 ‒ 2,1), ser ex-fumante (OR = 1,4; IC95% 1,3 ‒ 1,6) ou ser fumante (OR = 1,2; IC95% 1,03 ‒ 1,3) e consumir frutas e hortaliças 5 ou mais dias da semana (OR = 1,5; IC95% 1,1 ‒ 1,5). Conclusão: A importância do conhecimento da prevalência de doença cardíaca e fatores de riscos associados no atual contexto epidemiológico brasileiro deve ser ressaltada para orientar as ações de prevenção das doenças cardiovasculares, que representam a primeira causa de óbito no Brasil e no mundo.

ABSTRACT: Objective: To analyze the risk factors associated with the self-reported medical diagnosis of heart disease in Brazil. Methods: This is a cross-sectional study, analyzing information from 60,202 adult participants of the Brazilian National Health Survey in 2013. Heart disease was defined by self-reported medical diagnosis of heart disease. We analyzed associations between the occurrence of disease and sociodemographic characteristics, health conditions and lifestyle. A hierarchical binary logistic regression model was used. Results: The prevalence of self-reported diagnosis of heart disease in Brazil was 4.2% (confidence interval of 95% [95%CI] 4.0 ‒ 4.3) and was associated with females (odds ratio [OR] = 1.1; 95%CI 1.1 ‒ 1.1), people 65 years old or older (OR = 4.7; 95%CI 3.3 ‒ 5.6), poor or very poor health conditions (OR = 4.1; 95%CI 3.5 ‒ 4.6) and fair health conditions (OR = 2.4; 95%CI 2.2 ‒ 2.7), hypertensive individuals (OR = 2.4; 95%CI 2.2 ‒ 2.7), those with increased cholesterol (OR = 1.6; 95%CI 1.5 ‒ 1.8), overweight individuals (OR = 1.5; 95%CI 1.4 ‒ 1.8) and obese individuals (OR = 2.0; 95%CI 1.7 ‒ 2.2), sedentary behavior (OR = 1.5; 95%CI 1.02 ‒ 2.1), former smokers (OR = 1.4; 95%CI 1.3 ‒ 1.6) or current smokers (OR = 1.2; 95%CI 1.03 ‒ 1.3) and the consumption of fruits and vegetables 5 or more days each week (OR = 1.5; 95%CI 1.1 ‒ 1.5). Conclusion: The importance of knowledge on the prevalence of heart disease and associated risk factors in the present Brazilian epidemiological context must be emphasized because it guides actions to control and prevent cardiovascular diseases, the leading cause of death in Brazil and worldwide.

Epidemiología de las cardiopatías congénitas en Bogotá, Colombia, entre 2001 y 2014: ¿mejoría en la vigilancia o aumento en la prevalencia? / Epidemiology of congenital heart diseases in Bogotá, Colombia, from 2001 to 2014: Improved surveillance or increased prevalence?

Resumen Introducción. Las cardiopatías congénitas son alteraciones estructurales y funcionales del corazón, del sistema circulatorio y de los grandes vasos, que se desarrollan durante la embriogénesis cardiaca. A nivel mundial, dichos defectos son una causa importante de morbilidad y mortalidad en la población infantil. Objetivo. Determinar la prevalencia de cardiopatías congénitas en Bogotá durante el periodo de 2001 a 2014 y evaluar la tendencia en el tiempo. Materiales y métodos. Se analizóla informaciónde 405.408 recién nacidos registrados en el Programa de Vigilancia y Seguimiento de Niños con Anomalías Congénitas de la Secretaría de Salud de Bogotá y se calculó la prevalencia de las cardiopatías congénitas mediante un registro diario de nacimientos y su evaluación clínica y paraclínica. Las cardiopatías se clasificaron en aisladas, complejas y asociadas. Se halló la prevalencia por año y se evaluó la mortalidad en las primeras horas de vida. Resultados. La prevalencia de cardiopatías congénitas fue de 15,1 por cada 10.000 recién nacidos en todo el período, pero se evidenciaron valores por encima de 20 por 10.000 en los tresaños anteriores. Del total de recién nacidos evaluados, 46 % correspondió al sexo femenino, 53,16 % al sexo masculino y 0,33 % a sexo indeterminado. De los nacidos con malformaciones, 397 cardiopatías se clasificaron como aisladas, 142 se asociaron con otras malformaciones extracardiacas y 74 se consideraron complejas. Conclusiones. Las cardiopatías tienen gran impacto en la salud de la población infantil y, aunque la prevalencia es menor que en otros países, ello puede deberse al subregistro a nivel nacional. Se notó un aumento en la prevalencia en los tresaños anteriores, lo cual puede deberse a la implementación de los programas de vigilancia nacional y local. Sugerimos continuar desarrollando programas que incrementen e incentiven la tamización y el registro de estas enfermedades.

Abstract Introduction: Congenital heart diseases are functional and structural alterations of the heart, circulatory system, and large vessels, which develop during cardiac embryogenesis. These defects are significant causes of morbidity and mortality in children worldwide. Objective: To determine the prevalence of congenital heart diseases in Bogotá, Colombia, through the period 2001 to 2014 and evaluate the trend in time. Materials and methods: We analyzed 405,408 births from the Programa de Vigilancia y Seguimiento de Niños con Anomalías Congénitas de la Secretaría Distrital de Salud de Bogotá. We calculated the prevalence of congenital heart diseases through a daily registry of births, the clinical evaluation, and the work-up. Congenital heart diseases were classified as isolated, complex or associated. We estimated the prevalence per year and the mortality in the first hours of life. Results: The total prevalence of congenital heart diseases was 15.1 per 10,000 newborns; however, we obtained values above 20 per 10,000 newborns in the previous 3 years. Of the newborns analyzed, 46% were females, 53.16% were males, and 0.33% undetermined. Out of the newborns with congenital anomalies, 397 had congenital heart diseases, 142 of which were classified as associated and 74as complex. Conclusion: Congenital heart diseases have a significant impact on childhood morbidity and mortality. Although the prevalence continues to be low compared to other countries, this could be due to under registry nationwide. There was an increase in prevalence during the previous three years, which might be explained by the implementation of local and national programs. Therefore, we suggest continuing the development and promotion of such programs aimed at increasing screening and registration of these anomalies.

Manifestaciones cardiacas en la etapa aguda de la enfermedad de Kawasaki en un hospital pediátrico de tercer nivel en la Ciudad de México / Cardiac manifestations in the acute phase of Kawasaki disease in a third level children's hospital in Mexico City

Resumen Objetivo: Describir las manifestaciones cardiacas en la etapa aguda de la enfermedad de Kawasaki en pacientes atendidos en un hospital de tercer nivel de la Ciudad de México, México. Métodos: Estudio retrospectivo, descriptivo en pacientes con diagnóstico de enfermedad de Kawasaki de agosto de 1995 a diciembre del 2016 en el Instituto Nacional de Pediatría, México. Se estudio la demografía de los pacientes, características clínicas, tratamiento empleado y desarrollo de complicaciones cardiacas en la etapa aguda de la enfermedad. Resultados: Se estudiaron 508 casos de enfermedad de Kawasaki. La edad media al diagnóstico fue de 37.64 ± 35.56 meses. Predominio de pacientes masculinos del 65.4%, con una relación masculino/femenino de 1.88:1. La mayoría de los casos (79.2%) tuvo una presentación completa. La gammaglobulina intravenosa fue administrada en 92.4% de los casos. Veintiocho pacientes (5.5%) desarrollaron arritmias, se presentaron cambios en el segmento ST en 29 pacientes (5.6%) y 5 pacientes desarrollaron isquemia miocárdica. En el ecocardiograma inicial, 51 pacientes (9.9%) presentaron datos de miocarditis, 72 pacien- tes (14%) datos de pericarditis y 77 casos tuvieron derrame pericárdico (15%). Se detectaron alteraciones en las arterias coronarias en 169 casos (32.9%). Cuatro pacientes fallecieron en la etapa aguda de la enfermedad por complicaciones cardiacas de la enfermedad de Kawasaki. Conclusiones: En México cada vez existen más casos de enfermedad de Kawasaki con un alto porcentaje de manifestaciones cardiacas al diagnóstico. Se requiere de un mayor conocimiento de la enfermedad en México, para poder establecer cuál es la evolución cardiológica de los pacientes en el país.

Abstract Objectives: To describe the cardiac manifestations in the acute phase of patients with Kawasaki disease treated in a third level Children's hospital in Mexico City, Mexico. Methods: A cross-sectional study was conducted in patients with a diagnosis of Kawasaki disease treated in this hospital from August 1995 to December 2016. Information included patient demographics, clinical features, treatment used, electrocardiographic findings, extra-coronary echocardiographic findings, and the development of coronary artery aneurysms in the acute phase of the disease. Results: The study included 508 cases of Kawasaki disease, with a mean age at diagnosis of 37.64 ± 35.56 months (range from 2 to 200 months). Almost two-thirds (65.4%) of the patients were male, with a male/female ratio of 1.88:1. Complete Kawasaki disease was diagnosed in 79.2% of cases. Almost all cases (92.4%) received intravenous immunoglobulin. Twenty-eight patients (5.5%) developed arrhythmias, ST changes developed in 29 patients (5.6%), and 5 patients presented with ischaemic changes. In the initial echocardiographic evaluation, 51 patients (9.9%) were diagnosed with myocar- ditis, 72 patients (14.0%) with pericarditis and 77 cases (15.0%) developed pericardial effusion. Coronary artery anomalies were detected in 169 cases (32.9%). 32 cases were diagnosed as giant coronary aneurysms. Four patients died from cardiac complications in the acute phase of the disease. Conclusions: There has been an increase in the diagnosis of Kawasaki disease in Mexico. They presented with more cardiac complications than reported in literature. An increased knowledge of Kawasaki disease is required in Mexico in order to establish the cardiac outcomes of this group of patients.