ABSTRACT
Resumen El síndrome de Austrian es una tríada que engloba neumonía, meningitis y endocarditis causadas por Staphylococcus pneumoniae. Dado el aumento en el uso de antibióticos, cada vez vemos esta enfermedad de forma menos frecuente en la práctica clínica diaria. No obstante, se debe recordar su existencia ya que el conocimiento de esta entidad puede ser crucial en el pronóstico de estos enfermos. Desconocer algunos síndromes por presentar una frecuencia menor en los tiempos actuales no exime de mantener la buena práctica clínica ya que de ello puede depender el devenir del paciente. Se presenta un caso de síndrome de Austrian en un paciente joven, quien tuvo evolución tórpida los primeros días de ingreso; finalmente, tras la realización de varias pruebas, se solicitó un ecocardiograma que fue la clave para el diagnóstico. Se trata de un caso de interés para reflexionar en que, a pesar de poseer nuevas tecnologías a nuestro alcance en la actualidad, es preciso recordar la importancia de una buena exploración física.
Abstract Austrian syndrome is a triad that includes pneumonia, meningitis, and endocarditis caused by Staphylococcus pneumoniae. Given the increase in the use of antibiotics, it is becoming less common to see this disease in daily clinical practice. However, it should be remembered that it exists since knowledge of this condition could be crucial in the prognosis of these patients. To not recognise some syndromes due to currently having a lower frequency does not exempt maintaining good clinical practice, since the outcome of the patient may depend on this. A case of Austrian syndrome is presented in a young patient, who had a slow response in the first days of admission. Finally, after performing several tests, a cardiac ultrasound was requested, which was key for the diagnosis. It is an interesting case to reflect that, despite currently having new technologies within our reach, it is essential to remember the importance of a good physical examination.
Subject(s)
Humans , Middle Aged , Endocarditis , Pneumonia , Echocardiography , MeningitisABSTRACT
Introducción y objetivos: La osteogénesis imperfecta (OI) es una enfermedad del tejido conectivo que se caracteriza por una síntesis anómala del colágeno tipo i. Se sabe poco sobre la afectación cardiovascular que presentan estos pacientes. Las descritas con más frecuencia son la disfunción valvular y la dilatación de la aorta. Hemos querido analizar los cambios estructurales y funcionales del corazón en pacientes adultos con OI. Métodos: Estudiamos prospectivamente 82 pacientes con OI y los comparamos con 60 sujetos sanos emparejados por edad y sexo. A todos se les realizó un estudio ecocardiográfico. Resultados: No encontramos diferencias en la incidencia de valvulopatías respecto al grupo control. Nuestros pacientes tenían un mayor tamaño de la aurícula izquierda y mayores diámetros del ventrículo izquierdo (VI) ajustados por superficie corporal. La raíz de la aorta era significativamente mayor. La fracción de eyección del VI en los pacientes con OI era menor y tenían una presión sistólica de la arteria pulmonar mayor. Conclusiones: Los pacientes con OI presentan cambios estructurales y funcionales en el corazón. Sería recomendable un seguimiento para ver la evolución de estos cambios
Introduction and objectives: Osteogenesis imperfecta (OI) is a connective tissue disease characterised by an anomalous synthesis of type i collagen. Little is known about the cardiovascular affectation suffered by these patients. The most frequently described are valvular dysfunction and dilatation of the aorta. We wanted to analyse the structural and functional changes of the heart in adult patients with OI. Methods: We prospectively studied 82 patients with OI and compared them with 60 healthy subjects matched for age and sex. All of them underwent an echocardiographic study. Results: We found no differences in the incidence of valvulopathies compared to the control group. Our patients had a larger left atrium and larger left ventricle (LV) diameters adjusted for body surface area. Aortic root was significantly higher. LV ejection fraction in patients with OI was lower and they had higher pulmonary artery systolic pressure. Conclusions: Patients with OI suffer structural and functional changes in the heart. A follow-up is recommended to observe the evolution of these changes
Subject(s)
Humans , Male , Female , Adolescent , Young Adult , Adult , Middle Aged , Osteogenesis Imperfecta/complications , Heart/physiopathology , Collagen/metabolism , Heart Valve Diseases/epidemiology , Adult , Case Reports , Echocardiography/methods , Prospective Studies , Stroke Volume/physiologyABSTRACT
INTRODUCTION AND OBJECTIVES: Osteogenesis imperfecta (OI) is a connective tissue disease characterised by an anomalous synthesis of type i collagen. Little is known about the cardiovascular affectation suffered by these patients. The most frequently described are valvular dysfunction and dilatation of the aorta. We wanted to analyse the structural and functional changes of the heart in adult patients with OI. METHODS: We prospectively studied 82 patients with OI and compared them with 60 healthy subjects matched for age and sex. All of them underwent an echocardiographic study. RESULTS: We found no differences in the incidence of valvulopathies compared to the control group. Our patients had a larger left atrium and larger left ventricle (LV) diameters adjusted for body surface area. Aortic root was significantly higher. LV ejection fraction in patients with OI was lower and they had higher pulmonary artery systolic pressure. CONCLUSIONS: Patients with OI suffer structural and functional changes in the heart. A follow-up is recommended to observe the evolution of these changes.
Subject(s)
Aorta/pathology , Hypertrophy, Left Ventricular/pathology , Myocardium/pathology , Osteogenesis Imperfecta/pathology , Adolescent , Adult , Aorta/diagnostic imaging , Body Surface Area , Case-Control Studies , Echocardiography , Female , Heart/diagnostic imaging , Humans , Hypertrophy, Left Ventricular/diagnostic imaging , Male , Osteogenesis Imperfecta/complications , Osteogenesis Imperfecta/physiopathology , Prospective Studies , Stroke Volume , Ventricular Function, Left , Young AdultABSTRACT
BACKGROUND AND OBJECTIVES: Osteogenesis imperfecta is a rare disease with abnormal synthesis of type 1 collagen that affects diverse extra-skeletal tissues. Aortic root dilatation and valvular dysfunction have been described. Our purpose was to evaluate the prevalence of cardiac abnormalities in patients with osteogenesis imperfecta in comparison with an age and sex-matched control group of healthy people. PATIENTS AND METHODS: We prospectively studied 26 patients with osteogenesis imperfecta and compared them with 25 healthy people. All patients underwent a transthoracic standard M-mode, 2D and colour Doppler study. RESULTS: We did not find significant differences between both groups in the left ventricular diastolic and systolic function and the incidence of valvulopathies. The dimensions of the aortic root, left atrium and left ventricle when indexed by body surface area were significantly larger in patients with osteogenesis imperfecta compared with the control group, which was probably due to the reduced body surface of these patients. However there was a significant difference in the aortic root/telediastolic diameter of left ventricle ratio independent of the body surface, which was higher in patients with osteogenesis imperfecta. CONCLUSIONS: The incidence of valvular disease in osteogenesis imperfecta is similar to that of the normal population. However aortic root is larger in the former patients and is related to the left ventricular diastolic diameter.
Subject(s)
Heart Defects, Congenital/diagnostic imaging , Heart Defects, Congenital/etiology , Osteogenesis Imperfecta/complications , Case-Control Studies , Child , Female , Heart Defects, Congenital/epidemiology , Humans , Male , Prevalence , Prospective Studies , UltrasonographyABSTRACT
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