[Recurrent cardiac tamponade secondary to postpericardiotomy syndrome]. / Taponamiento cardíaco recidivante secundario a síndrome postpericardiotomía.

A 22-year-old woman underwent surgical repair of a secondary atrial septal defect. Thirty-five days after surgery, she developed fever, systemic venous congestion, and respiratory symptoms and chest pain. The echocardiogram demonstrated pericardial effusion (PE) quantified at approximately 3,500 cc, with signs of cardiac tamponade (CT). Pericardiocentesis was performed and symptomatology subsides when Prednisone 10 mg was administered every 24 h. Fourteen days after discharge, she was readmitted due to progressive dyspnea, orthopnea and fatigue. The echocardiogram showed the reappearance of PE and a mild CT. Prednisone 40 mg/day was given. After 10 days an echocardiogram showed are duction of the PE (600 cc) and the clinical condition of the patient improved. Three months later, PE disappeared in the echocardiogram and the patient remained asymptomatic.

[Nutritional evaluation and functional class in hospitalized cardiopathy patients]. / Evaluación nutricional y clase funcional del cardiópata hospitalizado.

The nutritional state evaluation of any patient with heart disease must include the anthropometric measures, organic metabolic and cellular immunity test. We evaluated the nutritional state of 75 hospitalized patients with heart disease, and its correlation with New York Heart Association class and heart disease type. There was 36 patients (48%) with normal nutritional state, 24 (32%) with grade I malnutrition, 12 (16%) with grade II malnutrition, and 3 (4%) with grade III malnutrition. Of 23 patients with rheumatic valvular heart disease 83.4% have some degree of malnutrition, 37 patients with ischemic heart disease 25% was under nourished. Fifty percent of patients with hypertensive cardiopathy, 75% of the patients with cardiomyopathy and 83% of the 7 patients with other type of heart disease had some degree of malnourishment. There was a direct correlation between nutritional state and functional class, we found no patient in IV class functional with normal nutritional state, or grade I malnutrition.

[Plasma fibrinogen during the acute stage of angina or myocardial infarct]. / El fibrinógeno plasmático durante la etapa aguda de angina o infarto del miocardio.

We prospectively studied the fibrinogen plasma levels of patients with acute myocardial infarction (AMI) and unstable angina (UA) whose diagnosis was based on clinical, electrocardiographical, enzymatic or pirophosphate scintigraphy data. Forty patients were included, 21 with AMI and 19 with UA, each group as well as both were compared to 10 normal individuals. The AMI group consisted of 15 male and 6 female with ages ranging from 35 to 69 years (mean 56.4); the UA group included 15 male and 4 female with an range from 38 to 69 (mean 53.1); the control group was made up 4 male and 6 female with an age range from 28 to 62 years (mean 52.3). All patients had plasma determination of fibrinogen, protrombin time, partial tromboplastin time, platelet count, cholesterol and risk factor for coronary artery disease were obtained on admission. There were no significant differences in regard to platelet count or coagulation times. Fibrinogen was elevated (> 450 mg/ dL) in 27 patients: 15 with AMI: 9 with UA and 3 normal individuals. The comparison of plasma fibrinogen levels between the control group and AMI patients was 397 +/- 131 vs 695 +/- 174, respectively (p < 0.001). Comparison between control group and the UA patients was 397 +/- 131 vs 455 +/- 108, respectively (p = 0.19 NS), and the comparison between the control group and AMI and UA patients gives 397 +/- 131 vs 534 +/- 164 (p < 0.001): Elevated fibrinogen seems to be a contributing factor for coronary artery disease and seems to be a risk factor with as much weight as any other.