Recurrencia de miocardiopatía por estrés posterior a terremoto en Chile: Reporte de un caso clínico / Recurrence of stress cardiomyopathy after an earthquake: Report of one case

Stress-induced cardiomyopathy is characterized by transient systolic dysfunction ofthe apical or mid segments ofthe left ventricle that mimics myocardial infarction in the absence of obstructive coronary artery disease. Symptoms recur after a phy-sical or emotional stress. We report a 77 years oíd femóle that in 2004, suffered an episode of stress cardiomyopathy after an intense physical effort. In February 2010, immediately after the earthquake that occurred in Chile, the patient consulted for chestpain, STsegment elevation and enzyme elevation. An echocardiography showed a left ventricular anteroseptal akinesia with an ejection fraction of 35 percent. Coronary arteriography did not show significant alterations.

Características de la insuficiencia cardíaca en pacientes con fracción de eyección preservada: Resultados del Registro Nacional de Insuficiencia Cardíaca, Grupo ICARO / Characteristics of heart failure with preserved ejection fraction: Results of the Chilean National Registry of Heart Failure, ICARO

Background: Heart failure (HF) with preserved ejection fraction (EF) is a condition of growing interest due to its high prevalence and difficult management. Aim: To evaluate the clinical profile of patients hospitalized with HF and preserved EF in Chilean hospitals. Material and Methods: Prospective registry of 15 centers. Among 649 patients hospitalized in functional class III and IV, an echocardiogram was performed to 353. Preserved EF was defined quantitatively as an EF >50%. Results: Out the 353 patients, 45% presented an EF >50%. Mean age in patients with EF >50 and ­50% was 66±13 and 67±13 years, respectively. Among patients with HF and EF >50%, the proportion of women was higher (73.7 and 36.3%, p <0.001), the proportion of patients with a history of hypertension (76.8 and 65.5%, p <0.05) and the presence of atrial fibrillation was also higher (62.3 and 47.8%, p <0.01) and a history of myocardial infarction was lower (17.1 and 29.5%, p <0.05). The diastolic diameter of the left ventricle was significantly lower in HF with preserved EF (51.0+10 and 63.5+10 mm respectively, p <0.001). No differences in the length of hospital stay and mortality were observed between HF with depressed and preserved EF. Female gender was an independent predictor for the presence of HF with preserved EF (Odds ratio: 2.62; confidence intervals: 1.1-6.1). Conclusions: HF and preserved EF is common among hospitalized patients, particularly in women and subjects with a history of hypertension and atrial fibrillation. Hospitalization length and mortality were similar in patients with either preserved or depressed EF.