RESUMO
La fibrilación auricular es la arritmia sostenida más frecuente ya lo largo del tiempo ha mantenido su relevancia debido a su alta morbimortalidad. Desde 105 trabajos iniciales para comprender su fisiopatología, pasando por las épocas farmacológicas y hasta los tiempos actuales que prometen cura en un alto porcentaje de los casos, esta patología ha centrado la atención de los clínicos debido a un escaso entendimiento de su génesis, la pobre respuesta general a las terapias disponibles y el riesgo asociado a la enfermedad tromboembólica. La suma de 105 factores descritos hace difícil la toma de conductas y requiere siempre un análisis caso a caso para la mejor decisión individual. Se revisarán aspectos de la fisiopatología, manejo actual y algunas perspectivas futuras de esta entidad.
Atrial Fibrilation is the most common sustained cardiac arrhythmia and it is recognized as being responsible for significant morbidity and increased mortality. If we think about the initial works to understand its pathophysiology, the pharmacologic therapy and the present time that promise a high percentage of cure, this disease had centered clinical attention because of a few knowledge of its onset, failure to therapy and high risk of tromboembolic stroke. The sum of these factors makes a difficult clinical decision and always need a case to case analysis for better individual choice. This work is a review of the pathophysiology, clinical management and future outlook of this entity.
Assuntos
Humanos , Fibrilação Atrial/fisiopatologia , Fibrilação Atrial/terapia , Fibrilação Atrial/classificaçãoRESUMO
Pulmonary hypertension associated to HIV infection has been reported in the literature with increased frequency. Apparently, this condition has a faster clinical evolution and a higher mortality than primary pulmonary hypertension. The pathogenic mechanisms of HIV associated pulmonary hypertension and the influence of its treatment on patientÕs evolution are not well known. We report a 32 years old homosexual male that developed a severe dyspnea in a period of 2 months. Echocardiogram demonstrated right ventricular dilatation and a systolic pulmonary artery pressure of 86 mm Hg. No other causes for pulmonary hypertension were found. Antiviral therapy and vasodilator treatment with a calcium channel blocker were started and the patient had an important subjective clinical improvement