Lipoma cardiaco / Cardiac masses

Resumen Las masas cardiacas son entidades raras que cursan con un espectro muy variado de manifestaciones clínicas que van desde cuadros asintomáticos hasta compromiso hemodinámico severo. Entre las lesiones benignas, los lipomas cardiacos son los segundos en frecuencia. Corresponden principalmente a lesiones neoplásicas benignas; no obstante, se pueden presentar otras patologías como trombos, vegetaciones y variantes de la normalidad. Gracias a la disponibilidad de técnicas de imagen de alta definición, como la ecocardiografía, la TC y la RM, ha aumentado su detección y tratamiento temprano. En el ámbito terapéutico se ofrece manejo quirúrgico, pues las imágenes no permiten la caracterización y diferenciación fidedigna de la naturaleza de las masas cardiacas. Se describe el caso de una paciente sin antecedentes cardiovasculares, con historial de disnea crónica, en quien se identificó, a través de estudios imagenológicos, masa cardiaca adosada al ventrículo con deformación leve de cavidades derechas. Fue llevada a resección quirúrgica y por histopatología se confirmó lipoma. Este hallazgo es el más infrecuente de todos los tumores cardíacos benignos. Se resalta la importancia del conocimiento de esta enfermedad para dar tratamiento eficaz y oportuno en aras de evitar complicaciones que impacten en morbimortalidad.

Abstract Cardiac masses are rare entities that present with a very varied spectrum of clinical manifestations that go from asymptomatic to pictures with severe hemodynamic compromise, within these, cardiac lipomas are the second in frequency within benign lesions. They mainly correspond to benign neoplastic lesions, however, other pathologies such as thrombi, vegetations and variants of normality can occur. Thanks to the availability of high-definition imaging techniques, echocardiography, CT and MRI have increased early detection and treatment. In the therapeutic field, surgical management is offered, since the images do not allow the characterization and reliable differentiation of the nature of cardia masses. It is described the case of a patient with no cardiovascular history, with chronic dyspnea, in whom the presence of CM attached to the ventricle with slight deformation of the right cavities is identified by imaging studies. Was taken to surgical resection confirming the presence of lipoma by histopathology, being this finding the rarest of all benign cardiac tumors. We highlight the importance of knowing this pathology to provide effective and timely treatment to avoid complications that impact morbidity and mortality.

When to Use Antibiotics in COVID-19: A Proposal Based on Questions.

The COVID-19 pandemic has affected millions of people, including hundreds of deaths. The search for adequate treatments and interventions that influence poor prognostic factors and reduce mortality has led to excessive use of antibiotics based on the possible existence of bacterial co-infection. However, there is no evidence to justify the systematic use of antimicrobials in COVID-19. The recommendations seek to provide knowledge regarding treatment; standardizing a management algorithm requires validation in clinical trials and studies of greater methodological rigor.

Multimodality cardiac imaging in the diagnostic approach to chronic dyspnea: a patient with pericardial lipoma.

Cardiac masses are rare entities that present with a very varied spectrum of manifestations ranging from asymptomatic to severe hemodynamic compromise. They mainly correspond to benign neoplastic lesions; however, other pathologies may occur. The availability of high-definition imaging techniques has increased early detection. Nevertheless, these techniques do not allow the characterization and reliable differentiation of the nature of the mass. We describe a patient with no cardiovascular history with a chronic dyspnea, in whom the presence of a cardiac mass attached to the ventricle with slight deformation of the right cavities was identified by imaging studies. The patient underwent surgical resection, which confirmed the presence of lipoma by histopathology. This finding is the rarest of all benign cardiac tumors.

Cardiac lipomas are rare benign tumors of the heart. They are usually asymptomatic, but when symptoms occur, they are usually nonspecific, so it is necessary to consult an internist, cardiologist or pulmonologist for proper study, identification and treatment. Multimodal images are very useful in these cases.