[Peripartum cardiomyopathy: clinical key to diagnosis]. / Miocardiopatía periparto: claves clínicas para su sospecha.

Peripartum cardiomyopathy (PPCM) is an idiopathic cardiomyopathy that is caused by heart failure secondary to a dysfunction of the left ventricle at the end of pregnancy or in the first months following childbirth. The diagnosis is performed by electrocardiogram, radiography of the thorax and increase of natriuretic peptides. Bedside radiography can contribute with data that help early diagnosis. Treatment is carried out following clinical guidelines for heart failure, taking into account potentially teratogenic drugs. The importance of this pathology lies in that it affects women at a fertile age and is potentially mortal, which is why there must be a high index of suspicion for its diagnosis and a differential diagnosis with other entities. In this clinical note we present a series of cases of PPCM with the goal of reviewing the diagnosis and treatment of this entity.

[Non-invasive diagnosis of cardiac amyloidosis due to transthyretin. Case report]. / Diagnóstico no invasivo de amiloidosis cardiaca por transtirretina. Caso clínico.

Amyloidosis due to deposits of transthyretin (ATTR) is currently considered the most frequent form of cardiac amyloidosis and its incidence is increasing thanks to the advances in diagnostic imaging techniques. Some non-invasive diagnostic criteria have recently been published on this entity that due to the development of new drugs for the specific treatment of cardiac ATTR, have prognostic and therapeutic implications. That is why cardiac ATTR could cease to be a rare disease and become a frequent one, and become potentially treatable instead of incurable. We present the case of an 80-year-old male diagnosed with non-hereditary cardiac ATTR by means of gammagraphy with 99mTc diphosfonate scintigraphy (99mTc-DPD) following the new criteria of non-invasive diagnosis.

Endoscopic treatment in an elderly patient with Bouveret syndrome / Manejo endoscópico de una paciente de edad avanzada con síndrome de Bouveret.

We report the case of a 94-year-old woman with Bouveret's syndrome, where endoscopic treatment was performed. Bouveret's syndrome is a gastric outlet obstruction due to gallstone impaction within the duodenum. It is the least frequent presentation of gallstone ileus. Gallstone ileus is a complication of cholelithiasis and has a high morbidity and mortality. Therefore, it requires an early diagnosis and urgent treatment, which is usually surgical. The peculiarity of this case is that we obtained the full resolution of the symptoms by endoscopic treatment in an elderly patient with high surgical risk.