[Skin lesions and renal failure after myocardial infarction]. / Lesiones cutáneas e insuficiencia renal tras infarto agudo de miocardio.

We describe the clinical case of a patient with acute myocardial infarction treated with t-PA fibrinolysis, who developed renal failure and cutaneous lesions of the livedo reticularis type, probably caused by embolization of cholesterol crystals. The main characteristics of this rare clinical entity are reviewed.

[Heart effect of arterial hypertension. Heart hypertrophy as a risk factor. Study technics (electrocardiogram, echocardiography, exercise test and Holter]. / Repercusión cardíaca de la hipertensión arterial. Hipertrofia cardíaca como factor de riesgo. Técnicas de estudio (electrocardiograma, ecocardiografía, prueba de esfuerzo y Holter).

Left ventricular hypertrophy, a known consequence of hypertension, is associated with an excess mortality independent of other known cardiovascular risk factors. There are multiple mechanisms in which left ventricular hypertrophy may account for this excess mortality including increased incidence of arrhythmias, systolic an diastolic dysfunction, relative ischemia, and associated coronary artery disease. Diastolic dysfunction, manifested by reduced ventricular distensibility of the hypertrophic left ventricle, appears to be an early characteristic of the hypertensive heart since echocardiographic techniques have demonstrated diastolic filling abnormalities in untreated essential hypertensives even before significant left ventricular hypertrophy appears. The presence of left ventricular hypertrophy is difficult to detect by electrocardiography. Echocardiography seems to be the best non-invasive method for the detection of hypertensive heart disease: it shows early abnormalities of left ventricular compliance, frequently left ventricular hypertrophy and late abnormalities of myocardial contractility.