[Prevalence of coronary anomalies detected by computed tomography at the Instituto Nacional Cardiovascular- INCOR]. / Prevalencia de anomalías coronarias detectadas por tomografía computarizada en el Instituto Nacional Cardiovascular - INCOR.

Objective: : To determine the prevalence of coronary anomalies (CA) in patients evaluated by 64-detector computed tomography (CT) at the Instituto Nacional Cardiovascular in Peru between 2016 and 2020. Materials and methods: Retrospective observational study, coronary artery CT scans of 1486 patients were performed on a 64-detector row CT scanner and reviewed in search for coronary anomalies. Results: The prevalence of CA detected by CT was 4.71% (70 cases) of which 64.3% were male. Abnormalities of origin were the most frequent, of which the origin of a coronary artery from the opposite coronary sinus was the most common (48.6%), with the right coronary being the main anomalous artery (31%), and the main path was interarterial (31%). Anomalous origin of the left main coronary from the pulmonary artery was found in 5 patients. Among the anomalies of the intrinsic coronary arterial anatomy the most frequent was the double left anterior descending artery (10%). Coronary fistulas accounted for 11.4% of cases. Conclusions: The prevalence of CA detected by 64-detector CT in a Peruvian institute was 4.71%. The most frequent coronary anomaly was the origin of the right coronary artery from the left coronary sinus with interarterial trajectory.

[Compliance with the cardiology residency training program during the COVID-19 pandemic, Lima-Peru]. / Cumplimiento del programa de formación del residentado en cardiología durante la pandemia COVID-19, Lima-Perú.

Objective: To characterize compliance with the annual curricular program of second and third-year cardiology residents in hospital of Lima-Peru during the COVID-19 pandemic. Materials and methods: A cross-sectional study was conducted, through a questionnaire applied to seventy-eight cardiology residents from the second and third year of specialty. We evaluated the compliance with rotations in clinical fields, individual compliance with the annual program, and the achievement of minimum training standards. Results: Compliance with rotations in clinical fields was highly variable (from 7.9% in Cardiac Rehabilitation for the second year to 90.9% for imaging in cardiology). Regarding individual compliance, 98.7% did not manage to comply with the annual program. Finally, only the standard of evaluation by radionuclides of myocardial function and perfusion was achieved by all residents, concerning the scope of the other achievements, variations are reported from 4.4% for performing stress tests to 75.8% in the to participate in interventional cardiology procedures. Associations were found between compliance with rotations with the type of health organization and type of university. Conclusions: The COVID-19 pandemic has considerably affected the training of cardiology residents, mainly due to non-compliance with the annual curriculum.

[Recurrent ischemia following acute myocardial infarction in the elderly. Unusual initial presentation of Takayasu's arteritis]. / Isquemia recurrente posterior a infarto agudo de miocardio en el adulto mayor. Insólita presentación inicial de arteritis de Takayasu.

We present the case of a 62-year-old male who presented with oppressive chest pain and was then diagnosed with acute myocardial infarction and received reperfusion treatment with primary angioplasty. In the evolution, he had a new episode of myocardial infarction, so complementary studies were carried out that led to the diagnosis of Takayasu's arteritis. Unfortunately, he presented a torpid evolution despite the established management. The clinical presentation in patients older than 60 years is uncommon, so it is important to consider it within the differential diagnosis in patients with diffuse coronary disease and recurrent myocardial ischemia, due to the rapid progression and high morbidity and mortality despite successful revascularization strategies.

[Cardiac Tamponade due to Rupture of a Giant Coronary Aneurysm over Coronary Fistulas: Report of an Unusual Case]. / Taponamiento Cardíaco por Ruptura de Aneurisma Coronario Gigante sobre Fístulas Coronarias: Reporte de un Caso Inusual.

Coronary artery fistulas are rare clinical entities and their association with giant coronary aneurysms is even more unusual. Most fistulas are asymptomatic, but aneurysms could develop symptoms depending on their diameter. We present a patient with chest pain and cardiac arrest, who later developed cardiac tamponade that needed emergency surgery, due to rupture of a giant coronary aneurysm developed from confluent coronary artery fistulas from two coronary arteries to pulmonary artery.

[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.

[Association between the risk of major depression and low physical activity in peruvian workers studying in universities]. / Asociación entre el riesgo de depresión mayor y el bajo nivel de actividad física en trabajadores peruanos que cursan estudios universitarios.

In order to assess if an association exists between the risk of major depression (RMD) and physical activity (PA), controlling for demographic and academic variables in workers enrolled in undergraduate studies at a private university in Lima, Peru, we carried out a cross-sectional study of 1,111 people. We used the Major Depression Inventory (MDI) and the International Physical Activity Questionnaire (IPAQ) to measure RMD and PA, respectively. RMD prevalence was 4.2%. In the multiple regression model adjusted for age, gender, unemployment and hours of sleep, low levels of PA were associated with increased odds of RDM (OR: 2.15, 95% CI: 1.16 to 4.00). We conclude that there is an association between RMD and PA in the study population, independent of demographic and academics factors. Strategies to improve screening and development of longitudinal studies to assess causality are suggested.

Asociación entre el riesgo de depresión mayor y el bajo nivel de actividad física en trabajadores peruanos que cursan estudios universitarios / Association between the risk of major depression and low physical activity in peruvian workers studying in universities

Con el objetivo de evaluar si existe asociación entre el riesgo de depresión mayor (RDM) y la actividad física (AF) controlado por variables sociodemográficas y académicas en trabajadores que cursan estudios de pregrado en una universidad privada de Lima, se desarrolló un estudio de corte transversal analítico en 1111 personas. Se utilizó el inventario de depresión mayor y el cuestionario internacional de actividad física, para medir RDM y AF, respectivamente. La prevalencia de RDM fue 4,2 %. En el modelo de regresión de múltiples variables - ajustado por edad, sexo, desempleo y horas de sueño- la AF baja se asocia con un incremento de la odds de RDM (OR 2,15; IC 95%:1,16û4,00). Se concluye que existe asociación entre la RDM y la AF en la población estudiada, la cual es independiente de factores sociodemográficos y académicos. Se sugieren mejorar estrategias de tamizaje y el desarrollo de estudios longitudinales para evaluar causalidad...

In order to assess if an association exists between the risk of major depression (RMD) and physical activity (PA), controlling for demographic and academic variables in workers enrolled in undergraduate studies at a private university in Lima, Peru, we carried out a cross-sectional study of 1,111 people. We used the Major Depression Inventory (MDI) and the International Physical Activity Questionnaire (IPAQ) to measure RMD and PA, respectively. RMD prevalence was 4.2%. In the multiple regression model adjusted for age, gender, unemployment and hours of sleep, low levels of PA were associated with increased odds of RDM (OR: 2.15, 95% CI: 1.16 to 4.00). We conclude that there is an association between RMD and PA in the study population, independent of demographic and academics factors. Strategies to improve screening and development of longitudinal studies to assess causality are suggested...