Archivos de cardiologia de Mexico最新文献

Introduction: Patients with aortic coarctation frequently present a delay in diagnosis mainly in newborns and infants, since the respiratory symptoms predominate in this age group. The absence of an adequate physical examination, with emphasis on the palpation of the pulses in the four extremities, in addition to the absence to obtain of blood pressure, condemns these patients to a fortuitous finding or event before the diagnosis can be made.

Method: Retrospective, descriptive and observational study.

Results: Three patients under 1 year of age were included in the study. We present the "way of the cross" to reach the diagnosis, its outcomes and treatment.

Conclusion: The primary clinical reflections for clinical diagnosis for the first contact physician are discussed.

Objective: To describe the cardiovascular risk from Mexican patients scheduled to initiate cancer treatment and to compare the risk between oncological and hematological malignancies.

Methods: We enrolled patients referred for echocardiography before initiating cancer therapies. Left ventricular ejection fraction (LVEF) and global longitudinal strain (GLS) was evaluated. To estimate the risk for developing cancer therapy-related cardiovascular toxicity (CTR-CVT) we used the Heart Failure Association-International Cardio-Oncology Society risk score (HFA-ICOS).

Results: 106 patients were studied, 83% (n = 88) had an oncological, and 17% (n = 18) a hematological malignancy. Breast cancer represented 89.8% (n = 79) of the oncological and lymphoma 61.1% (n = 11) of the hematological malignancies. Patients with oncological malignancies were older (55 ± 11 vs. 46 ± 14 years; p = 0.020) and more frequently female (95.5 vs. 44.4%; p < 0.001). Metastasis was more prevalent in patients with hematological malignancies (38.9 vs. 13.6%; p = 0.011). Mean LVEF was 59.42 ± 6.36 and mean GLS was 20.26 ± 4.89. Prevalence of borderline (50-54%) and reduced LVEF (< 50%) was 4.7 and 3.8%, respectively. Abnormal GLS (< 18%) was identified in 10.4%. HFA-ICOS classified 14.7% of oncological and 10.2% of hematological malignancies in the high and very high-risk categories for developing CTR-CVT (p = 0.68).

Conclusions: A high risk for developing CTR-CVT was identified in 14.2% of our population. This risk was comparable among oncological and hematological malignancies.

Acute respiratory distress syndrome (ARDS) is one of the main causes of postoperative respiratory failure, associated with a high mortality rate in patients undergoing cardiac surgery. Although there is robust evidence regarding the benefits of the prone position maneuver in terms of oxygenation, ventilatory mechanics, and mortality, it is not free of complications, and therefore of relative and absolute contraindications. A review of the literature was carried out regarding the safety and efficacy of the prone position maneuver in patients after recent cardiac surgery with median sternotomy who develop ARDS under invasive mechanical ventilation. It is concluded that, in an appropriate setting, with experienced personnel and necessary care, the prone position could be safe in this type of patients. Studies of higher methodological quality and with better discrimination of the reason for refractory hypoxemia are needed to determine the efficacy in patients who develop ARDS after cardiac surgery with median sternotomy in terms of in-hospital mortality.