Family long QT syndrome type 2 associated with KCNH2 gene mutation: aborted sudden cardiac death.

A complete screening was performed in a family after one of its members presented with a sudden cardiac death event. A genetical analysis revealed a mutation which led to a long QT syndrome.

Infective endocarditis: 10-year experience in a non-cardiovascular center.

BACKGROUND AND OBJECTIVE: Infective endocarditis (IE) is an infection with a poor prognosis, and an associated in-hospital mortality of at least 25%. Optimal therapy of IE requires long-term effective antibiotic therapy and valve surgery in many cases. The aim of this study was to review the demographics, bacteriology, and outcomes of patients with IE admitted to a tertiary referral center in Mexico City, over a 10-year period. METHODS: Retrospective cohort study of patients admitted at Instituto Nacional Salvador Zubiran with a new diagnosis of IE over a 10-year period, from January 2009 to January 2019. Patients who met the definition for definitive diagnosis of infective endocarditis according to the modified Duke criteria were included in the study. RESULTS: There were 62 patients (50.85 ± 17.46 years, 40.3% females) with IE. The culprit microorganism was identified in all cases, with Staphylococcus aureus being the most frequently found (34%). Valve surgery was performed in 58.1%, while 41.9% only received medical treatment. The mortality rate was 25.8% at 30 days and 41.9% at 12 months. Comparing the surgical and medical treatment groups, we found that 50% and 36% in each group, respectively, had died within 12 months of admission. CONCLUSIONS: Our center has a high prevalence of health care-associated endocarditis, mostly related to the presence of intravascular access devices. Most of the patients had a surgical indication. Patients with type 2 diabetes mellitus and decreased right ventricular systolic function had an increased mortality rate at 12 months.

Antecedentes y objetivo: La endocarditis infecciosa (EI) es una infección de mal pronóstico, con una mortalidad intrahospitalaria que va del 15-20%. La terapia óptima requiere antibioticoterapia efectiva por tiempo prolongado y cirugía valvular en algunos casos. El objetivo de este estudio fue revisar la epidemiología y desenlaces de pacientes con EI en un centro de referencia en la Ciudad de México. Métodos: Cohorte retrospectiva de pacientes admitidos al Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán con diagnóstico de EI en un periodo de 10 años, de enero de 2009 a enero de 2019. Se incluyeron a pacientes que cumplían la definición de diagnóstico definitivo de endocarditis infecciosa de acuerdo a los criterios modificados de Duke. Resultados: Se incluyeron a 62 pacientes (50.85 ± 17.46 años, 40.3% mujeres). Todos los casos tuvieron cultivos positivos, siendo S. aureus el microorganismo más frecuente (34%). El 58.1% de los pacientes recibió tratamiento quirúrgico y 41.9% recibió únicamente tratamiento médico. La mortalidad a 30 días fue de 25.8% y a 12 meses fue de 41.9%. Comparando los grupos de tratamiento médico y quirúrgico, se encontró que 50% y 36% de cada grupo, respectivamente, habían fallecido a los 12 meses. Conclusiones: Encontramos una alta prevalencia de EI asociada a los cuidados de la salud, principalmente en relación a accesos intravasculares. Casi todos los pacientes presentaban un criterio quirúrgico al momento del diagnóstico. Los pacientes con diabetes mellitus tipo 2 y función sistólica del ventrículo derecho disminuida presentaron una mayor mortalidad a 12 meses.

Abnormal Cardiovascular Findings in Acute Pancreatitis: Are They Associated with Disease Severity?

BACKGROUND: Acute pancreatitis (AP), a disease that commonly requires in-hospital treatment, has been associated with a high incidence of abnormal cardiovascular findings (ACFs). We conducted a prospective study to explore the association of these findings with severity of the disease. METHODS: Adult patients with AP diagnosis were prospectively enrolled in an observational study during an 8-month period in a tertiary care center. AP and its severity were defined according to the Revised Atlanta Classification of AP. Subjects were submitted to electrocardiographic, echocardiographic, and serologic testing during the acute period and a 3-month follow-up. The incidence of ACF was compared between two groups: (1) Mild and (2) moderate/severe cases. RESULTS: Twenty-seven patients (mean age 48 ± 17 years) with AP were enrolled; 15 (55%) had mild and 12 (45%) had moderate/severe AP. During the acute episode, 67% had increased pro-brain natriuretic peptide levels; 52% had abnormal electrocardiographic findings; 48% had abnormal echocardiographic findings; and 18% had increased troponin I levels. There was no significant difference in the incidence of ACF between mild and moderate/severe groups. Nineteen patients (70%) had repeated follow-up testing, and most of the initial ACF did not persist. CONCLUSION: ACFs occur in an important proportion of patients during AP episodes. Future research should continue to focus in the association of ACFs and the severity of the disease.

[Renal sympathetic denervation (RSD): a new, non-pharmacologic therapeutic strategy for treatment-resistant hypertension (TRH). Report of the first procedure in Mexico]. / Denervación simpática renal (DSR): una nueva terapéutica no farmacológica para la hipertensión arterial (HTA) resistente. Informe del primer procedimiento en México.

A patient with resistant hypertension successfully treated with sympathetic renal denervation (SRD) is reported. This novel therapy is based on the partial ablation of the renal nerves by applying radiofrequency to the luminal surface of the renal arteries using vascular catheterization techniques. This first case performed in Mexico has two particular features: (i) an electrophysiology ablation catheter was employed due to the unavailability of the system specifically designed for SDR, and (ii) under current denervation protocols, the anatomical complexity of the targeted renal arteries would have excluded our patient from this procedure and thus deprived her of the benefit provided.