El fondo histórico de la angina de pecho / Historical background of angina pectoris

El autor desarrola los principales hitos en la historia de la angina de pecho o angor pectoris, desde el denominado papiro de Ebers hasta nuestros días

The author develops the main milestones in the history of angina pectoris or angor pectoris, from the so-called Ebers papyrus to the present day

Heart disease and the stress hypothesis in the mid-twentieth century: a historical review

Abstract Background In the 1920s, heart disease (a noncommunicable disease), was the new leading cause of death in the USA. Simultaneously, experimental progress in the study of stress provided scientific justification for a new type of risk factor. The objective of the present work is to examine the history of heart disease as a public health problem and the contribution of advancements in scientific knowledge about stress in the 1930s-1960s supporting the hypothesis of stress as one cause of disease. Results In the process of studying heart disease risk factors in the 1950s, medical practitioners became responsible for the early detection of risk factors in order to "catch" chronic disease in its earliest stage. Coronary heart disease specifically was a disease of white, middle class, professional males, and "stress" was hypothesized as one reason why this population was particularly vulnerable. Walter Cannon and Hans Selye provided experimental evidence that stress might cause physical disease. In the 1930s, Cannon described how the body seeks to maintain homeostasis. When the body's systemic equilibrium is challenged by something dangerous in the environment or an insult directly to the body, the sympathetic nervous system (SNS) and adrenals are stimulated. In the 1940s and 1950s, Selye discovered that a universal triad of stress effects (hypertrophy of the adrenal glands, involution of the thymus and lymphoid tissue, and ulceration in the gastrointestinal tract) was seen repeatedly after any noxious or aversive event (i.e., noise, shock, etc.). The stress responses occurred in a certain pattern, known as the general adaptation syndrome or GAS. Autopsy from Selye's laboratory animals showed that, in addition to the general pathological effects of GAS, arteries were thickened and hardened, just as would be seen in human victims of heart and circulatory disorders. Conclusions Since then, large scale, prospective epidemiological studies, meta-analyses, and systematic reviews, as well as smaller scale basic science studies, have established the relationship between stress and heart disease development and progression. Most evidence centers on depression and the biobehavioral mechanisms underlying its contribution to heart disease. However, effective prevention/intervention strategies that improve stress and physical disease outcomes are still needed.

Anticoagulação durante gravidez de mulher portadora de cardiopatia: [revisão] / Anticoagulation during pregnancy of woman with heart diseases: [review]

Diretrizes em muito contribuem para minimizar os potenciais riscos obstétricos e fetais e melhorar a assistência durante o ciclo gravídico-puerperal. Contudo, há controvérsias a respeito do manuseio da anticoagulação em mulheres portadoras de cardiopatias. A importância deste assunto assenta-se no fato de que o tromboembolismo é considerado uma das principais causas de morte materna em portadoras de cardiopatia, o que torna obrigatório o conhecimento sobre sua prevenção. A estratégia do tratamento antitrombótico é ponderada pelo risco de trombose imposto pela situação clínica materna e pelos efeitos adversos que os anticoagulantes podem causar ao concepto. Neste artigo, serão discutidas a estratificação do risco materno ao tromboembolismo, as propriedades dos anticoagulantes indicados para a sua prevenção e a estratégia terapêutica nos diversos momentos da gestação, parto e puerpério da mulher portadora de cardiopatia.

Guidelines provide great contribution to the reduction of potential obstetric and fetal risks and to the improvement of health care during pregnancy and puerperium. However, there are still controversies regarding the management of anticoagulation in women with heart diseases. The importance of this issue is based on the fact that thromboembolism is considered one of the main causes of maternal death in women with heart diseases; therefore, the acquisition of knowledge about how to prevent this disorder is mandatory. The strategy of the antithrombotic treatment is based on the risk of thrombosis imposed by the maternal clinical picture and on the adverse effects of the anticoagulants for the conceptus. In the present study, we discussed the stratification of maternal risk of thromboembolism, the properties of the anticoagulants indicated for its prevention, and the therapeutic strategy at different moments of pregnancy, delivery and puerperium of women with heart diseases.

Cardiopatia chagásica: cinquenta anos depois, um novo olhar / Chagas heart disease: fifty years later, a new look

Revisões históricas aos avanços científicos para o controle da doença, o Simpósio Internacional Comemorativo do Centenário da Descoberta da Doença de Chagas (1909-2009).

Avicenna's approach to cardiac diseases.

Abu Ali el Husain Bin Abdullah Bin Sina (980-1037 A.D.) known as 'Sheik et Rayees, Ibne-e-Sina' in Arab countries and 'Avicenna' in Western countries, was the first man who considered the psychology and emotions of human beings from physiological point of view, and gave the then, possible explanation of different emotional states and their effects on human body. He related psychology with medicine and proved that all emotional states e.g. pleasure, grief, anger and worry and the others are deeply concerned with the shape of the heart, types of blood and body fluids (humours). Not only he proved this but has also described the management and treatment of these conditions, and was the pioneer in this field. He discussed the action of drugs on heart and mentioned their indications and contra-indications. He based the morality and behaviour of a person on the temperament of the heart and spirit. According to him, appraising the particular characteristic behaviour of a person, information may be obtained about the temperament of the heart and spirit. He is of the opinion that different attributes of a person, e.g. boldness, cowardliness, misery, benevolence, happiness, sorrowfulness, worries and anger, etc. can be controlled and managed medically. Nobody, before him, had shed any light on this subjet.

Etienne Louis Arthur Fallot: una descripción más que centenaria / Etienne Louis Arthur Fallot: a description of over 100 years old

La perspectiva histórica ha sido siempre importante para una mejor comprensión de la Medicina. Este artículo revive la descripción original de un ade las cardiopatías más interesantes e ilustra la gran intuición de quien le dio el nombre. Se incluyen algunos comentarios sobre la actitud de Fallot frente a aspectos polémicos de esta cardiopatía, que históricamente resultan de interés