RESUMO
La Miocardiopatía no compactada (MCNC) representa una anomalía de la morfología miocárdica frecuentemente asociada a una etiología genética, sin embargo, hay escasas descripciones de su asociación con enfermedades autoinmunes. Se presenta revisión de la literatura y el caso de una paciente lúpica que ingresa con signos de insuficiencia cardiaca descompensada con confirmación de VINC por ecocardiograma y resonancia magnética nuclear cardiaca (RMN-C).
Non compacted cardiomyopathy (NCNC) frequently represents an abnormality of myocardial morphology associated with a genetic etiology, however, there are few descriptions of its association with autoimmune diseases. We present a review of the literature and the case of a lupus patient who was admitted with signs of decompensated heart failure with confirmation of VINC by echocardiography and cardiac nuclear magnetic resonance (C-MRI).
Assuntos
Feminino , Lúpus Eritematoso Sistêmico , Insuficiência Cardíaca , CardiomiopatiasRESUMO
Non-compacted cardiomyopathy (NCM) is a heterogenous myocardial disorder. Although much has been published in recent years, little is known about NCM in the neonatal period. The objective of this study is to characterize the involvement of newborns affected with NCM and to identify risk factors associated with increased mortality. This is a retrospective study including all neonates diagnosed with NCM between 2006 and 2018. Diagnosis was based on echocardiographic findings. Data were collected regarding prenatal history, gestational age and weight at birth, gender, age at diagnosis, left or biventricular involvement and associated malformations, medical and surgical treatments, and evolution. Fourteen patients were included. The median follow-up duration was 34 months (range 1-87 months). The left ventricular apex and lateral wall were involved in all cases (100%). Thirteen patients (92.8%) had other associated heart malformations. Six patients (42.8%) died during the follow-up period. Patients who had biventricular involvement and poor ventricular function presented a higher risk of death. The main cause of death was ventricular dysfunction (5/6 [83.3%]). During follow-up, eight patients (57.1%) underwent surgery for their cardiac malformations, without higher mortality. NCM must be included in the differential diagnosis of neonatal cardiomyopathy. The higher mortality observed in our series is related not only to the high association with congenital heart disease, but also to a greater presence of early and severe left ventricular dysfunction. We did not find that patients who underwent surgery with cardiopulmonary bypass had worse outcomes.
Assuntos
Cardiomiopatias/complicações , Cardiopatias Congênitas/complicações , Disfunção Ventricular Esquerda/complicações , Cardiomiopatias/mortalidade , Cardiomiopatias/fisiopatologia , Ecocardiografia , Feminino , Cardiopatias Congênitas/cirurgia , Humanos , Recém-Nascido , Masculino , Estudos Retrospectivos , Fatores de Risco , Disfunção Ventricular Esquerda/cirurgiaRESUMO
El presente caso corresponde a un paciente de un mes de vida, sexo masculino con diagnóstico de miocardiopatía no compactada asociada a defectos cardiacos congénitos. La miocardiopatía no compactada recién es incluida por la American Heart Association (AHA) como entidad propia a partir de la segunda mitad de la década pasada. El diagnóstico principalmente es ecocardiográfico. La sintomatología en menores de un año puede empezar con falla cardiaca. La evolución es variable con tendencia a la mejoría en algunos casos para finalmente en décadas posteriores se hace más pronunciada la falla cardiaca, eventos tromboembólicos, arritmias malignas y muerte súbita. El manejo esta en medicamentos para falla cardiaca, evitar arritmias malignas y eventos tromboembólicos.
The present case corresponds to a 1-month-old male patient with a diagnosis of non-compacted cardiomyopathy associated with congenital heart defects. Noncompacted cardiomyopathy is newly included by the AHA as its own since the second half of the last decade. The diagnosis is mainly echocardiographic. Symptoms in children under one year may start with heart failure. The evolution is variable and tends to improve in some cases. Finally, in later decades, heart failure, thromboembolic events, malignant arrhythmias and sudden death become more pronounced. The management is in medicines for heart failure, to avoid malignant arrhythmias and thromboembolic events.