[Update on functional mitral regurgitation: a comprehensive review]. / Actualización en insuficiencia mitral funcional: una revisión integral.

In recent decades, the advances in the management of functional mitral regurgitation (MR), makes knowledge of this disease extremely important to the clinical cardiologist, as it has an increasing prevalence in patients older than 50 years. The objective of this article is to review the pathophysiological bases of MR, in order to differentiate its mechanism, and to correlate them with the clinical, hemodynamic, and imaging findings that assess the severity of the disease. These data are relevant for the adequate selection of the patient and the opportune moment of the therapeutic interventions, which involves a multidisciplinary team in decision-making to achieve the greatest benefit within the treatment options of this pathology.

[Should I treat a high-risk chronic coronary syndrome in an invasive way from the beginning? No, in most cases]. / Controversias en Cardiología. Parte 2. ¿Debo tratar un síndrome coronario crónico de alto riesgo invasivamente desde el inicio? No, en la mayoría de casos.

The definition of the high-risk chronic coronary syndrome varies depending on the noninvasive test used to trigger ischemia. The triggering occurs through increased myocardial work and oxygen demand, either through exercise or drugs. The initial approach to the chronic coronary syndrome leads us to discuss in which cases to prioritize an optimal initial medical therapy or to perform an initial invasive procedure of myocardial revascularization. In this article, we analyze both approaches based on previous studies carried out to date, where the initial invasive management has not been shown to be superior to initial optimal medical therapy in outcomes such as death or major adverse cardiovascular events.