[Aortic coarctation: different anatomo-clinical forms depending on the age of presentation]. / Coartación de aorta: diferentes formas anatomoclínicas según la edad de presentación.

OBJECTIVE: To analyse the anatomo-clinical characteristics of the coarctation of the aorta at different ages of presentation as well as the findings and results of its surgical correction at different periods. PATIENTS AND METHODS: We retrospectively studied the clinical and angiographic data, as well as the intraoperative findings and surgical outcomes of 82 consecutive patients (54 M and 28 F) with coarctation of the aorta. Mean age was 16.2 +/- 13.7 years (1 month to 63 years). The patients were divided into three groups according to age: Group A (n = 10) under 1 year; Group B (n = 30) from 1 to 12 years and Group C (n = 42) over 12 years. RESULTS: A preductal form was found in 20.7% cases (50.0%, 30.0% and 7.1% of groups A, B, and C respectively; p = 0.003). An associated left-to-right shunt was present in 19.5% (40.0%, 16.7% and 16.7% of groups A, B and C respectively; p = NS). The first manifestation of the disease was different in groups A, B and C. Among group A patients, congestive heart failure was the most frequent presentation (70.0%). In group B, the most frequent presentation (30%) was as an incidental finding in an asymptomatic patient. Finally, systemic hypertension or its complications predominated among group C patients (38.0%). Left ventricular hypertrophy on ECG was present in 0.0%, 30.0% and 54.7% of patients in groups A, B and C (p = 0.003) respectively. Postoperative complications including death, hypertensive crisis and re-coarctation were observed in 90.0%, 33.3% and 21.4% in groups A, B and C (p = 0.01) respectively. CONCLUSIONS: Among patients with coarctation of the aorta, the age of clinical presentation allows us to define groups of patients with different anatomical characteristics, clinical course and postoperative outcome.

[Ventricular functional changes following an episode of accidental electrocution]. / Alteraciones funcionales de ventrículo tras un episodio de electrocución accidental.

We present a case of accidental electrocution in a 62-years-old male. After the accident he referred a non-specific thoracic pain that disappeared in a week, remaining asymptomatic since then. On the other hand, he shows a permanent electrocardiographic pattern of anterolateral subepicardial ischaemia. Myocardial function revealed by echocardiography and pertechnectate gammagraphy, showed an early primary damage, with a posterior slow tendency to recovery. Exercise treadmill test and Tallium-Dipyridamole test were normal, so an ischaemic background could be rejected in this case. No other diseases were presented, so the changes observed could be exclusively connected with the electrical accident.

[Occupational therapy in cardiac rehabilitation]. / Terapia ocupacional en rehabilitación cardíaca.

The occupational therapy in cardiac rehabilitation is aimed to decrease the physiologic and psychologic patient overwork, allowing the work return. It shows a more ergonomic way to do those dangerous tasks without risk. It is necessary because there are differences between the work done in the effort tests and his lifetime. The cardiac rehabilitation is an efficient share in coronary patient treatment and occupational therapy is a significant complementary procedure.