RESUMEN
OBJECTIVE: To describe clinical, microbiological and echocardiographic aspects of endocarditis in a specific group of patients without intracardiac devices or underlying structural heart disease. METHOD: Retrospective study, clinical records and echocardiographic reports were reviewed during the period 1997 to 2020. Duke's modified criteria were applied. Statistical analysis: univariate expressed in frequencies, using measures of dispersion and central tendency. RESULTS: 30,000 echocardiographic reports were reviewed, only 1350 had infectious endocarditis as a reason for sending, of which 248 cases were selected. The mean age was 48.1 ± 16.7 years. 140 men (56%) and 108 women (44%). The most frequent echocardiographic sign was vegetation, in 278 (93.60%), and most common location was mitral (35.55%), with a higher number of cases in the right ventricle than expected. The most common systemic disease was kidney disease, in 135 (41.08%). A case of Streptococcus thoraltensis not previously reported in Mexico was identified. CONCLUSIONS: The presence of infectious endocarditis has increased due to invasive in-hospital and drug procedures. Due to their complexity, multidisciplinary teams are indispensable.
OBJETIVO: Describir aspectos clínicos, microbiológicos y ecocardiográficos de endocarditis en un grupo específico de pacientes sin dispositivos intracardiacos ni cardiopatía estructural subyacente. MÉTODO: Estudio retrospectivo en el que se revisaron expedientes clínicos y reportes ecocardiográficos durante el periodo de 1997 a 2020. Se aplicaron los criterios modificados de Duke. Se describió la muestra por edad, sexo, enfermedad sistémica, vegetaciones y agente microbiológico. Se excluyeron pacientes con cardiopatía estructural o Libman-Sacks. Análisis estadístico: univariado expresado en frecuencias, utilizando medidas de dispersión y tendencia central. RESULTADOS: Se revisaron 30,000 reportes ecocardiográficos, de los cuales solo 1350 tenían como motivo de envío endocarditis infecciosa, y de estos se seleccionaron 248 casos. La edad promedio fue de 48.1 ± 16.7 años. Hubo 140 hombres (56%) y 108 mujeres (44%). El signo ecocardiográfico más frecuente fue la vegetación, en 278 (93.60%), y la ubicación más común fue mitral (35.55%), con un número mayor de casos en el ventrículo derecho de lo esperado. La enfermedad sistémica más común fue la enfermedad renal, en 135 (41.08%). Se identificó un caso de Streptococcus thoraltensis no reportado previamente en México. CONCLUSIONES: La presencia de endocarditis infecciosa ha aumentado debido a procedimientos invasivos intrahospitalarios y fármacos. Por su complejidad, los equipos multidisciplinarios son indispensables.
Asunto(s)
Endocarditis , Cardiopatías , Masculino , Humanos , Femenino , Adulto , Persona de Mediana Edad , Estudios Retrospectivos , Cardiopatías/diagnóstico por imagen , Cardiopatías/epidemiología , Cardiopatías/etiología , Endocarditis/diagnóstico por imagen , Endocarditis/epidemiología , Ecocardiografía , HospitalesRESUMEN
Focal atrial tachycardia is defined as supraventricular tachycardia originating from discrete sites from which activation spreads to both atrial. In most clinical series, atrial tachycardia account for about 5% of all supraventricular arrythmias. This tachycardia can occur in children or adults within and without structural heart disease. Three potential mechanisms are described for its origin: abnormal automaticity, triggered activity or microreentry. Catheter ablation has an important role in the management of focal atrial tachycardia and is now considered to be a first line therapy, can be improved with electroanatomical mapping system (CARTO) that allows reconstruction of the chamber geometry and allow visualization of the activation sequence; and can to improve the efficacy of catheter ablation.
Asunto(s)
Humanos , Ablación por Catéter , Taquicardia Atrial Ectópica , Taquicardia Atrial EctópicaRESUMEN
Focal atrial tachycardia is defined as supraventricular tachycardia originating from discrete sites from which activation spreads to both atrial. In most clinical series, atrial tachycardia account for about 5% of all supraventricular arrythmias. This tachycardia can occur in children or adults within and without structural heart disease. Three potential mechanisms are described for its origin: abnormal automaticity, triggered activity or microreentry. Catheter ablation has an important role in the management of focal atrial tachycardia and is now considered to be a first line therapy, can be improved with electroanatomical mapping system (CARTO) that allows reconstruction of the chamber geometry and allow visualization of the activation sequence; and can to improve the efficacy of catheter ablation.
