RESUMEN
Although there exist many relevant data about the significant influence of psychosocial risk factors for coronary artery disease, there is no reliable concept for an integrated psycho-somato-social primary prevention for CAD. So this article is to be a first attempt on such a psycho-somatic primary prevention, based on the well known psycho-social risk factors. Referring to the pathological and psycho-physiological effects of these risk factors the need of equal assessment of all risk factors will be discussed. There will also be introduced a comprehensive risk evaluation and the possibility of a psychcardiological consultation.
Asunto(s)
Enfermedad Coronaria/prevención & control , Prevención Primaria/métodos , Medicina Psicosomática/métodos , Estrés Psicológico/prevención & control , Enfermedad Coronaria/etiología , Enfermedad Coronaria/psicología , Consejo , Humanos , Terapia por Relajación , Factores de Riesgo , Estrés Psicológico/diagnóstico , Estrés Psicológico/fisiopatologíaRESUMEN
Coronary Angioplasty (PTCA) has become one of the standard procedures in the therapy of coronary heart disease. One of the main issues is the 20-40% incidence of restenosis of the dilated vessel. Up to now, the subject of predictors of restenosis has not yet been sufficiently clarified. Our study is concerned with two questions; first, is it possible to prove any connections between the amount of restenosis and psychosocial factors? Second, is it possible to distinguish groups of patients with and without subsequent restenosis on the basis of psychosocial variables, even before the diagnostic coronary angiography? 138 (91m, 47f) patients were assessed before the diagnostic coronarangiography, the 25 PTCA-patients (20m, 5f) were furthermore reassessed three months after the PTCA (the time of the angiographic control). Somatic and social data were collected and a semistandardised interview was conducted. In addition, coping, stress-coping control over disease and health and life-contentment were determined. Highly significant correlations was found between the amount of restenosis and resignative stress-coping, self-pity, depressive coping and flight-tendency. With the help of stress-coping-subtests (which were given at the first examination) it was possible to separate the group of patients with restenosis from the group without it.
Asunto(s)
Angioplastia Coronaria con Balón/psicología , Enfermedad Coronaria/psicología , Trastornos Psicofisiológicos/psicología , Adaptación Psicológica , Adulto , Anciano , Enfermedad Coronaria/terapia , Mecanismos de Defensa , Femenino , Humanos , Masculino , Persona de Mediana Edad , Infarto del Miocardio/psicología , Infarto del Miocardio/terapia , Determinación de la Personalidad , Trastornos Psicofisiológicos/terapia , Calidad de Vida , Recurrencia , Factores de Riesgo , Rol del Enfermo , Estrés Psicológico/complicacionesRESUMEN
It is well documented, that bradycardiac electrical heart activity disturbances occur very rarely in women of reproductive age. Therapy is in fact redundant in congenital AV-block. However, acquired AV-block in pregnancy constitutes a risk for both mother and child. In the following case, we report on an acquired third-degree AV-block, which worsened during the pregnancy from N.Y.H.A stage I to stage III, and hence required the implantation of a pacemaker during pregnancy.