Résumé
The bicuspid aortic valve corresponds to the most common valve defect in the general population. This can present asymptomatically as an incidental finding or symptomatically due to valve disease (stenosis and regurgitation), aortopathy, and infective endocarditis. Imaging techniques such as transthoracic and transesophageal echocardiography are fundamental pillars in diagnosis and treatment, determining the need for surgical intervention and the type of surgery to be performed. The case of a young patient with a less frequent bicuspid aortic valve phenotype is presented.
Sujets)
Humains , Mâle , Adulte , Maladies de l'aorte/étiologie , Maladies de l'aorte/génétique , Maladie de la valve aortique bicuspide/complications , Valvulopathies/diagnostic , Valve aortique/chirurgie , Thorax/imagerie diagnostique , Échocardiographie-doppler , Tomodensitométrie/méthodes , Échocardiographie transoesophagienneRésumé
Sudden death is the most serious complication of acute coronary syndromes. The highest percentage occurs at home with a very low survival rate. The highest risk group are patients with ejection fraction under 40% after an acute myocardial infarction. So far the indication of the clinical practice guides are the implantation of ICD as a secondary prevention, and as a primary prevention when the systolic function is severely diminished, however there is an interval of 40 days in which the implant has not managed to demonstrate benefits. In this critical period patients should be managed with beta-blockers. So far, the absolute benefit of using portable cardioverter-defibrillators as a prophylactic bridge to the ICD implant has not been demonstrated. The following revision is based on the most relevant clinical practice guides in the field carried out in relation to a clinical case
Sujets)
Humains , Mâle , Adulte d'âge moyen , Mort subite cardiaque/étiologie , Mort subite cardiaque/épidémiologie , Infarctus du myocarde/complications , Infarctus du myocarde/diagnostic , Coronarographie , Défibrillateurs implantablesRésumé
Antiplatelet therapy and percutaneous coronary intervention are two of the most important interventions in the management of coronary artery disease. In the last 20 years there has been groundbreaking advances in the pharmacotherapy and stent technology. Bleeding is the most feared complication of antiplatelet therapy, mainly due to the increase in major adverse cardiovascular events besides the bleeding itself. Different clinical decision tools have developed with the aim to define which patients have a high ischemic or bleeding risk, thus individualizing treatment.