Subject(s)
Humans , Female , Pregnancy , Adult , Pregnancy Complications, Cardiovascular/pathology , Respiratory Insufficiency/pathology , Shock, Cardiogenic/pathology , Thrombosis/pathology , Heart Valve Prosthesis/adverse effects , Mitral Valve , Pregnancy Complications, Cardiovascular/etiology , Pregnancy Trimester, First , Pulmonary Edema/pathology , Respiratory Insufficiency/etiology , Shock, Cardiogenic/etiology , Thrombosis/etiology , Prosthesis Failure , Fatal Outcome , Systemic Inflammatory Response Syndrome/etiology , Systemic Inflammatory Response Syndrome/pathologySubject(s)
Humans , Male , Aged , Shock, Cardiogenic/pathology , Cachexia/pathology , Cardiomyopathies/pathology , Myocardial Infarction/pathology , Pneumonia, Aspiration/pathology , Shock, Cardiogenic/physiopathology , Coronary Artery Disease/pathology , Cachexia/physiopathology , Fatal Outcome , Electrocardiography , Heart Failure/physiopathology , Heart Failure/pathology , Heart Ventricles/pathology , Lung/pathology , Cardiomyopathies/physiopathology , Myocardial Infarction/physiopathologySubject(s)
Female , Humans , Middle Aged , Endomyocardial Fibrosis/pathology , Endomyocardial Fibrosis/surgery , Shock, Cardiogenic/pathology , Atrial Fibrillation , Endomyocardial Fibrosis/physiopathology , Fatal Outcome , Heart Ventricles/pathology , Heart Ventricles/physiopathology , Shock, Cardiogenic/physiopathology , Time FactorsSubject(s)
Aged , Female , Humans , Inferior Wall Myocardial Infarction/pathology , Inferior Wall Myocardial Infarction/physiopathology , Shock, Cardiogenic/pathology , Shock, Cardiogenic/physiopathology , Coronary Angiography , Coronary Vessels/pathology , Electrocardiography , Fatal Outcome , Ventricular Septal Rupture/pathology , Ventricular Septal Rupture/physiopathologySubject(s)
Aged , Humans , Male , Acute Coronary Syndrome/pathology , Shock, Cardiogenic/pathology , Angioplasty , Acute Coronary Syndrome/etiology , Acute Coronary Syndrome/therapy , Anterior Wall Myocardial Infarction/complications , Anterior Wall Myocardial Infarction/pathology , Atherosclerosis/pathology , Coronary Vessels/pathology , Fatal Outcome , Heart Arrest/therapy , Shock, Cardiogenic/etiology , Shock, Cardiogenic/therapy , Ventricular Fibrillation/therapySubject(s)
Humans , Male , Middle Aged , Myocardial Infarction/pathology , Shock, Cardiogenic/pathology , Coronary Artery Disease/complications , Coronary Artery Disease/pathology , Diabetic Angiopathies/pathology , Echocardiography , Fatal Outcome , Hypertension/complications , Hypertension/physiopathology , Myocardial Infarction/therapy , Shock, Cardiogenic/therapySubject(s)
Female , Humans , Middle Aged , Heart Valve Prosthesis Implantation/adverse effects , Mitral Valve Insufficiency/pathology , Mitral Valve Stenosis/pathology , Rheumatic Heart Disease/pathology , Dyspnea/etiology , Echocardiography , Fatal Outcome , Mitral Valve Insufficiency/surgery , Mitral Valve Stenosis/surgery , Reoperation , Rheumatic Heart Disease/surgery , Shock, Cardiogenic/pathologySubject(s)
Aged , Female , Humans , Cardiomyopathy, Restrictive/pathology , Pulmonary Embolism/pathology , Shock, Cardiogenic/pathology , Cardiomyopathy, Restrictive/complications , Diagnosis, Differential , Electrocardiography , Fatal Outcome , Pulmonary Embolism/complications , Shock, Cardiogenic/etiologyABSTRACT
Las respuestas hemodinámicas y cardiovasculares a una TEP masiva son HAP grave, insuficiencia ventricular derecha y choque cardiogénico. El estado irreversible de esta última condición y la mortalidad pueden estar en relación con un infarto del ventrículo derecho secundario, entidad descrita desde 1949. Reportamos un caso clínico, en que el estudio de necropsia demostró una TEP masiva y, como hallazgo relevante, un infarto reciente del ventrículo derecho en presencia de arterias coronarias sin enfermedad aterosclerosa significativa. Se analiza la importancia del infarto del ventrículo derecho como un indicador mayor de riesgo para mortalidad, su perfil clínico y hemodinámico, así como la cascada de fenómenos isquémicos que culminan en necrosis del ventrículo derecho y en un estado de choque cardiogénico irreversible. Se subraya la importancia de la detección temprana de tal infarto para iniciar una terapéutica que logre una rápida lisis del trombo. Esto con el objeto de rescatar miocardio y preservar la viabilidad del ventrículo derecho. Este podría ser el primer caso en nuestro medio, en donde se demuestra la asociación de una TEP masiva y un infarto del ventrículo derecho, como factor determinante de mortalidad