Síndrome coronario agudo perioperatorio, a propósito de un caso / Perioperative acute coronary syndrome, a case report

El síndrome coronario agudo adquiere una gran importancia en Anestesiología. En primer lugar desarrollan IAM perioperatorio un porcentaje de pacientes que oscila entre el 0,1 % y el 5,6 %. A esto se suma que el periodo perioperatorio representa un intervalo temporal con mucha inestabilidad para el paciente isquémico que se somete a una intervención quirúrgica. El diagnóstico puede ser complicado (ausencia de dolor torácico, dificultad para objetivar cambios en el ECG y elevación habitual de enzimas cardiacas). Por último el tratamiento recomendado puede tener implicaciones para la anestesia y la cirugía realizada. Presentamos un caso clínico de una paciente con factores de riesgo cardiovascular que durante la colocación de una prótesis total de rodilla bajo anestesia epidural sufre un síndrome coronario agudo (AU)

In anesthesia, acute coronary syndrome has a great importance. Firstly, a percentage of patients ranging between 0,1 % and 5,6 % develop perioperative acute coronary syndrome. Perioperative period represents an interval with instability for ischemic patient who undergoes surgery. Diagnosis can be complicated (absence of chest pain, difficult to objectify ECG changes or habitual cardiac enzyme rise) and finally, recommended treatment may have implications for anesthesia and surgery performed.We report a clinical case of a patient with cardiovascular risk factors who suffers an acute coronary syndrome during a total knee replacement under epidural anesthesia (AU)

Síndrome de Takotsubo: a propósito de un caso / Tako-tsubo syndrome: report of a case

Se presenta el caso de una mujer de 72 años de edad, ingresada en la UCI con diagnóstico de Síndrome Coronario Agudo Sin Elevación del ST (SCASEST). El cateterismo cardíaco demostró la integridad de su árbol coronario, siendo diagnosticada finalmente de Síndrome de Takotsubo (AU)

This report presents the case of a 72 years-old woman, who was admitted in ICU with a diagnostic of non-ST-segment elevation acute coronary syndrome (NST-ACS). Cardiac catheterization showed a normal coronary angiogram, and the final diagnostic was TakoTsubo Syndrome (AU)

[2 cases of transposition corrected in adulthood. The value of computed tomography and isotopic angiography and a review of the literature]. / Dos casos de transposición corregida en la edad adulta. Interés de la tomografía computadorizada y la angiografía isotópica y revisión de la literatura.

Corrected transposition of the great arteries is an unusual congenital heart defect, above all at ages over 40. Echocardiography and invasive angiography are still cornerstones for its diagnosis. However other non-invasive techniques, such radionuclide angiocardiography and computed tomography, not so used in this malformation, can help us in its detection. We present 2 cases of corrected transposition of the great arteries in adults in which these methods were used and review the literature.

[Percutaneous transluminal valvuloplasty in severe pulmonary stenosis in an aged patient. Presentation of a case]. / Valvuloplastia transluminal percutánea en la estenosis pulmonar severa del paciente anciano. Presentación de un caso.

We report a case of severe pulmonary stenosis in a 74 year old patient who was successfully treated by means of percutaneous transluminal valvuloplasty. This relatively simple technique is extensively used in children. However, its use is considered exceptional in old patients.