Síndrome de ALCAPA en adulto: caso clínico / Anomalous left coronary artery origin from the pulmonary artery causing angina: report of one case

Anomalies of the origin of coronary arteries are detected in 0.5-1.5% of all angiographies. Anomalous origin of the left main trunk is the most uncommon and its origin from pulmonary artery in adults is exceptional, usually because it is associated with a short survival. We report a 49-year-old female, presenting with a two months history of angina. The exercise electrocardiogram suggested ischemia. A coronary angiography was performed, showing the absence of the left main trunk in the left coronary sinus, a dilated right coronary artery, with no lesions and extensive collateral circulation to the anterior descending and circumflex arteries, with inverted flow and the left main trunk draining to the pulmonary artery. The left ventricle was mildly dilated with middle and apical anterior hypokinesia. Global systolic function was conserved. A surgical correction was decided, occluding the left main anomalous origin and performing a coronary artery bypass grafting from the left internal thoracic artery. The patient was discharged with no complications. At two years of follow-up she is symptom free and has a normal physical capacity.

Riesgo para trastornos de la conducta alimentaria en estudiantes secundarios y su relación con la composición por sexo del colegio / Risk for eating disorders in secondary students and their relation with the composition by sex of the school

Introduction: eating disorders(ED)are chronic mental illnesses, highly prevalent within adolescent population, affecting women more than men. Generally, ED are triggered by an unsatisfactory self body-image, which relates to several socio-cultural factors. Objective: To study the prevalence of the risk of developing ED within Chilean high school students, and to evaluate its relation with sex and the school gender composition (SGC): single-sex or coeducational. Method: A transversal-analytic study was performed using three Santiago public high schools: female-exclusive, male-exclusive and coeducational. The Eating Attitudes Test-40 was applied, considering a 30-point score to define qualitatively the risk condition. Results: The sample included 415 students, 52 percent women, with a mean age of 15,9 years (range 14 to 18). The global prevalence of risk for ED was 14,9 percent. The risk condition was significantly higher in women (25,2 percent) than men (4 percent). No differences were found when comparing the prevalence of risk according to the type of school. Discussion: The higher risk for ED among women respect to men was confirmed, and the SGC has no influence on this risk.

Infarto agudo al miocardio en octogenarios, caracterización y comparación con pacientes menores en 20 años de registro / Acute myocardial infarction in octogenarians, characterization and comparison with younger patients in 20 years of registry

Cardiovascular diseases are the main cause of death in Chile, being acute myocardial infarction (AMI) the most frequent. Its incidence increases with age, so, as the population gets older; a higher number of cases is expected. Despite this, AMI within octogenarian patients (OP) has been understudied in our country and worldwide; there are no specific guidelines for their management, only a few isolated studies that reveal the poor applicability of the standard treatments indicated in AMI clinical guidelines. Objective: To describe the clinical features, initial treatment, in-hospital evolution and five-year outcome of OP with AMI, and compare them to patients under 80 years of age. Method: Consecutive registration of all patients diagnosed with AMI that were hospitalized in our coronary unit between 1988 and 2007. Description of clinical features, in-hospital and 5-year evolution of all OP cases. Comparison to the younger group of patients through chi-square or t-student tests, considering p-value...

Daño hepático crónico como manifestación de pericarditis constrictiva: reporte de un caso / Chronic liver failure as a manifestation of constrictive pericarditis: report of a case

Constrictive pericarditis (CP) is an uncommon condition which clinical presentation becomes very unspecific, making its diagnosis a hard challenge. It has multiple and varied causes, all of them determine pericardium inflammation and progressive fibrosis that restricts heart filling and develops diastolic dysfunction, expressing mainly as right heart failure. Symptoms of this last condition allow posing different diagnosis as they can appear in many other diseases, including chronic liver disease as happens in the following clinical case. A 27 year-old male patient with a history of progressive edema on his extremities, increased abdominal volume, a 3-month body weight loss, and dyspnea; is firstly diagnosed as CLD after medical Evaluation. However, etiological studies for CLD appear negative and the patient does not respond to general approaches, motivating his hospitalization for further studies. Cardiologic tests reveal pulmonary hypertension, which is studied by MRI showing a thickened pericardium suggesting constriction that is confirmed by cardiac catheterization. The patient undergoes surgery without incidents and a favorable post-operatory period, being completely asymptomatic 3 months later. This clinical case reflects how difficult can become diagnosing CP; as well as presenting the right way to study these patients in order to confirm this alternative diagnosis, the treatment of choice, and the excellent results that surgery can achieve. Finally, CP is a rare condition that must be included within differential diagnosis of patients with clinical manifestations of RHF.