RESUMEN
Background: Cardiovascular complications can occur in up to 80% of adolescent patients with eating disorders (ED) and account for 30% of their mortality. Aim: To evaluate cardiovascular complications in adolescents with ED and their evolution after refeeding. Patients and Methods: In adolescents with ED admitted to treatment, we assessed the nutritional status, weight loss prior to consultation, presence of bradycardia (BC, defined as heart rate < 60 bpm), we performed an electrocardiogram (ECG) and an echocardiography and measured thyroid hormones. Results: We studied 53 women aged 16.4 ± 2.3 years. Fifteen had a diagnosis of Anorexia Nervosa (AN), seven of Bulimia (BN), eight a not otherwise specified ED (ED-NOS), four a Binge Eating Disorder (BED), sixteen an Atypical Anorexia (AAN) and three an Atypical Bulimia (ABN). Thirty four percent were malnourished and 3.8% overweight. The most common cardiac problem was BC in 51%. In eight of 26 patients in whom an echocardiogram was done, it was abnormal. Six had a decreased ventricular mass, three a pericardial effusion and three valvular involvement. There was a significant association between bradycardia and malnutrition, weight loss and low free triiodothyronine levels. BC was significantly more common in patients with AN, but it also occurred in half of the patients with AAN and in one of three patients with other types of ED. At follow up, bradycardia significantly improved with refeeding. Conclusions: There is an association between all types of ED and bradycardia, as well as anatomical and functional cardiac anomalies.
Asunto(s)
Humanos , Femenino , Niño , Adolescente , Adulto Joven , Bradicardia/etiología , Trastornos de Alimentación y de la Ingestión de Alimentos/complicaciones , Bradicardia/fisiopatología , Ecocardiografía , Pérdida de Peso/fisiología , Trastornos de Alimentación y de la Ingestión de Alimentos/fisiopatología , Índice de Masa Corporal , Factores de Riesgo , Análisis de Varianza , Estudios de Cohortes , Estadísticas no Paramétricas , Desnutrición/complicaciones , Desnutrición/fisiopatología , ElectrocardiografíaRESUMEN
El trauma vascular sigue siendo una entidad trascendente en el ámbito de la cirugía. El presente artículo intenta actualizar logros recientes en este campo e incluirlos en una exposición global coherente. Se exponen aspectos generales del desarrollo histórico de la cirugía vascular, se señalan los diversos mecanismos que pueden ocasionar esta patología y se intenta normar sobre la terminología en ella involucrada. Se describen los caracteres semiológicos más relevantes de los traumatismos vasculares, se indican los recursos de laboratorio necesarios y se expone la técnica quirúrgica que debe emplearse en estas lesiones