RESUMEN
El síndrome de Bayés es una nueva entidad clínica, caracterizada por la combinación de bloqueo interauricular (BIA) avanzado en el electrocardiograma de superficie con fibrilación auricular (FA) y otras arritmias auriculares. Este síndrome se asocia con un riesgo incrementado de ictus, demencia y mortalidad. El BIA avanzado se diagnostica con la presencia de una onda P ≥ 120ms de morfología bifásica (±) en derivaciones de cara inferior. Se produce por un bloqueo completo del haz de Bachmann que causa una despolarización retrógrada de la aurícula izquierda desde zonas cercanas a la unión auriculoventricular. La miocardiopatía auricular fibrótica es el sustrato anatómico del BIA avanzado. La disincronía inducida por el BIA avanzado funciona como desencadenante y mecanismo de mantenimiento de la FA. Esta alteración de la arquitectura auricular produce remodelado auricular, estasis sanguínea e hipercoagulabilidad, lo cual desencadena la cascada trombogénica. El BIA avanzado, incluso sin arritmias auriculares documentadas, también se ha relacionado con FA, ictus, demencia y mortalidad. Sin embargo, todavía no se ha demostrado el beneficio de la anticoagulación para los pacientes sin FA documentada. Por lo tanto, es recomendable una búsqueda proactiva de FA en los pacientes con BIA avanzado
Bayés syndrome is a new clinical entity, characterized by the association of advanced interatrial block (IAB) on surface electrocardiogram with atrial fibrillation (AF) and other atrial arrhythmias. This syndrome is associated with an increased risk of stroke, dementia, and mortality. Advanced IAB is diagnosed by the presence of a P-wave ≥ 120ms with biphasic morphology (±) in inferior leads. The cause of IAB is complete Bachmann bundle blockade, leading to retrograde depolarization of the left atrium from areas near the atrioventricular junction. The anatomic substrate of advanced IAB is fibrotic atrial cardiomyopathy. Dyssynchrony induced by advanced IAB is a trigger and maintenance mechanism of AF. This alteration of the atrial architecture produces atrial remodeling, blood stasis and hypercoagulability, triggering the thrombogenic cascade. The presence of advanced IAB, even in patients without documented atrial arrhythmias, has also been associated with AF, stroke, dementia, and mortality. However, in these patients, there is no evidence to support the use of anticoagulation. Therefore, in patients with advanced IAB, a proactive search for AF is recommended
Asunto(s)
Humanos , Bloqueo Interauricular/complicaciones , Fibrilación Atrial/complicaciones , Arritmia Sinusal/complicaciones , Síndrome , Accidente Cerebrovascular/etiología , Demencia/etiología , Electrocardiografía/métodosRESUMEN
Se presenta el caso de una paciente vinculada al programa de atención prenatal de una entidad promotora de salud (EPS). Se trata de una femenina de 30 años de edad, con embarazo de 20.5 semanas por fecha de última menstruación, con extrasístoles ventriculares aisladas sin fenómenos repetitivos y taquicardia sinusal inapropiada. A los 31 días de iniciado el tratamiento con metoprolol 25mg cada 12 horas vía oral, el feto presentó disminución progresiva del crecimiento. La restricción del crecimiento intrauterino fue el principal hallazgo durante los sesenta y tres días de uso de metoprolol. Se realizó una evaluación por la sospecha de evento adverso, utilizando el algoritmo de Naranjo y se determina que los efectos de metoprolol en el crecimiento intrauterino fetal eran plausibles (categoría probable). Se realiza la intervención para la suspensión del metoprolol y se observa ganancia de peso progresiva. Se logró un feto con adecuado peso al nacer
This is the case of a patient who was attended by a health care entity. She was a 30-year-old patient and 20.5 weeks pregnant according to the first day of the last menstrual period. She was diagnosed by a cardiologist with isolated ventricular extra-systoles without repetitive phenomena and inappropriate sinus tachycardia. After 31 days being treated with oral metoprolol 25mg bid, the fetus showed a progressive decline of growth rate. The intrauterine growth restriction was the main clinical finding during the sixty-three days of metoprolol consumption. Naranjo algorithm was used to evaluate the causality of the adverse event. It was determined that the effects of metoprolol on fetal intrauterine growth were plausible (probable). Metoprolol was ceased. Then a progressive borned of weight was observed. A fetus with adequate birth weight was achieved
Asunto(s)
Humanos , Femenino , Embarazo , Adulto , Retardo del Crecimiento Fetal/inducido químicamente , Metoprolol/efectos adversos , Antiarrítmicos/efectos adversos , Arritmia Sinusal/complicaciones , Arritmia Sinusal/tratamiento farmacológico , Edad Gestacional , Factores de RiesgoRESUMEN
OBJECTIVE: Recently, long noncoding RNAs (lncRNAs) have caught more attention for their role in the progression of many diseases. Among them, lncRNA GAS5 (Growth Inhibition Specificity 5) was studied in this research to identify how it affects the progression of atrial fibrillation (AF). PATIENTS AND METHODS: In 40 patients with AF and 30 patients with sinus rhythm (SR), the GAS5 expression of the right atrial appendage (RAA) tissues was detected by the quantitative Real Time-Polymerase Chain Reaction (qRT-PCR). Moreover, the cell proliferation assay was conducted in AC16 cells transfected with GAS5 inhibitor and mimics, respectively. Furthermore, the qRT-PCR was performed to uncover the mechanism. RESULTS: In the research, the expression of GAS5 in RAA tissues was decreased significantly in AF patients than that in SR ones. Moreover, overexpression of GAS5 inhibited cell growth in AC16 cells, while knockdown of GAS5 promoted cell growth in AC16 cells. In addition, further experiments revealed that ALK5 was a target of GAS5 and its expression in AF tissues negatively correlated to GAS5 expression. CONCLUSIONS: These results indicate that GAS5 could inhibit cell proliferation of AF via suppressing ALK5, which may offer a new vision for interpreting the mechanism of AF development.
Asunto(s)
Fibrilación Atrial/patología , ARN Largo no Codificante/metabolismo , Receptor Tipo I de Factor de Crecimiento Transformador beta/metabolismo , Arritmia Sinusal/complicaciones , Arritmia Sinusal/genética , Arritmia Sinusal/patología , Apéndice Atrial/metabolismo , Apéndice Atrial/patología , Fibrilación Atrial/complicaciones , Fibrilación Atrial/genética , Línea Celular , Proliferación Celular , Fibroblastos/citología , Fibroblastos/metabolismo , Regulación de la Expresión Génica , Humanos , Interferencia de ARN , ARN Largo no Codificante/antagonistas & inhibidores , ARN Largo no Codificante/genética , ARN Interferente Pequeño/metabolismo , Receptor Tipo I de Factor de Crecimiento Transformador beta/antagonistas & inhibidores , Receptor Tipo I de Factor de Crecimiento Transformador beta/genéticaRESUMEN
No disponible
Asunto(s)
Humanos , Femenino , Adulto , Fibrosis Endomiocárdica/diagnóstico por imagen , Ventrículos Cardíacos/diagnóstico por imagen , Hallazgos Incidentales , Fibrosis Endomiocárdica/patología , Fibrosis Endomiocárdica/terapia , Ventrículos Cardíacos/patología , Electrocardiografía , Arritmia Sinusal/complicaciones , Arritmia Sinusal/diagnóstico por imagen , Diagnóstico Diferencial , EspañaRESUMEN
No disponible
Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Anciano , Arritmias Cardíacas/inducido químicamente , Arritmias Cardíacas/complicaciones , Taquicardia/inducido químicamente , Taquicardia/complicaciones , Propofol/efectos adversos , Cardioversión Eléctrica , Arritmia Sinusal/inducido químicamente , Arritmia Sinusal/complicaciones , Antiarrítmicos/uso terapéuticoRESUMEN
Although elevated resting heart rate is related to poor outcomes in heart failure (HF) with reduced ejection fraction, the association in HF with preserved ejection fraction (HFpEF) remains inconclusive. Therefore, we conducted a dose-response meta-analysis to examine the prognostic role of heart rate in patients with HFpEF.We searched PubMed and Embase databases until April 2017 and manually reviewed the reference lists of relevant literatures. Random effect models were used to pool the study-specific hazard ratio (HR) of outcomes, including all-cause death, cardiovascular death, and HF hospitalization.Six studies with 7 reports were finally included, totaling 14,054 patients with HFpEF. The summary HR (95% confidence interval [CI]) for every 10âbeats/minute increment in heart rate was 1.04 (1.02-1.06) for all-cause death, 1.06 (1.02-1.10) for cardiovascular death, and 1.05 (1.01-1.08) for HF hospitalization. Subgroup analyses indicated that these positive relationships were significant in patients with sinus rhythm but not in those with atrial fibrillation. There was also evidence for nonlinear relationship of heart rate with each of the outcomes (All P for nonlinearityâ<â.05).Higher heart rate in sinus rhythm is a risk factor for adverse outcomes in patients with HFpEF. Future trials are required to determine whether heart rate reduction may improve the prognosis of HFpEF.
Asunto(s)
Insuficiencia Cardíaca/mortalidad , Insuficiencia Cardíaca/fisiopatología , Frecuencia Cardíaca/fisiología , Volumen Sistólico/fisiología , Anciano , Arritmia Sinusal/complicaciones , Arritmia Sinusal/fisiopatología , Fibrilación Atrial/complicaciones , Fibrilación Atrial/fisiopatología , Causas de Muerte , Femenino , Insuficiencia Cardíaca/etiología , Hospitalización/estadística & datos numéricos , Humanos , Masculino , Persona de Mediana Edad , Pronóstico , Modelos de Riesgos Proporcionales , Factores de RiesgoRESUMEN
Left atrial (LA) thrombus is a known sequela of atrial fibrillation (AF) but it is less frequently encountered in patients in sinus rhythm. Left ventricular (LV) dysfunction may predispose patients without evidence of atrial tachyarrhythmias to atrial thrombosis. Warfarin is the standard treatment for cardiac chamber thrombosis and prevention of the associated thromboembolic complications. Despite that apixaban was found to be superior to warfarin in prevention of stroke and systemic embolism in patients with AF, evidence for its use in treatment of cardiac chamber thrombi is scarce and is limited to case reports. We report a case of simultaneously occurring LV and LA thrombi successfully treated with reduced dose apixaban in a patient with ischaemic cardiomyopathy and in sinus rhythm. Although apixaban maybe a potential effective treatment for intracardiac thrombi, further studies are needed to demonstrate efficacy and safety of this agent in larger patient populations.
Asunto(s)
Arritmia Sinusal/complicaciones , Cardiomiopatías/complicaciones , Trombosis Coronaria/tratamiento farmacológico , Inhibidores del Factor Xa/administración & dosificación , Isquemia Miocárdica/complicaciones , Pirazoles/administración & dosificación , Piridonas/administración & dosificación , Anciano , Arritmia Sinusal/fisiopatología , Cardiomiopatías/fisiopatología , Trombosis Coronaria/etiología , Atrios Cardíacos/fisiopatología , Ventrículos Cardíacos/fisiopatología , Humanos , Masculino , Isquemia Miocárdica/fisiopatologíaRESUMEN
Los tumores cardíacos primarios son entidades de rara aparición. Un 50% son mixomas y aparecen en adultos (edad media 56 años) y principalmente en mujeres. Presentamos un caso de un mixoma auricular diagnosticado en una paciente de 25 años de edad durante el segundo trimestre de la gestación. El tratamiento de elección es la exéresis quirúrgica, que en este caso fue realizada tras finalización de la gestación en la semana 35 de amenorrea (AU)
Primary cardiac tumors are rare appearance entities. 50% are myxomas and appear in adults (mean age 56 years) and especially in women. We report a case of atrial myxoma diagnosed in a 25 years old during the second trimester of pregnancy. The treatment of choice is surgical excision, which in this case was made after completion of pregnancy in week 35 of amenorrhea (AU)
Asunto(s)
Humanos , Femenino , Embarazo , Adulto , Complicaciones del Embarazo/fisiopatología , Mixoma/cirugía , Mixoma , Arritmia Sinusal/complicaciones , Arritmia Sinusal , Cirugía Torácica/métodos , Segundo Trimestre del Embarazo , Amenorrea/terapia , Ecocardiografía , Osteogénesis Imperfecta/genética , Electrocardiografía , Neoplasias Cardíacas , Procedimientos Quirúrgicos Cardíacos/métodosRESUMEN
This study aimed to examine the discrete impacts of peak oxygen consumption (VO2) and brain natriuretic peptide (BNP) levels on future heart failure (HF) events in sinus rhythm (SR) and atrial fibrillation (AF). A total of 1447 patients who underwent symptom-limited cardiopulmonary exercise testing and whose BNP values were determined simultaneously were analysed (SR, N = 1151 and AF, N = 296). HF events were defined as HF hospitalization or HF death. Over a mean follow-up period of 1472 days, 140 HF events were observed. A high BNP value (dichotomized by median value) was independently associated with HF events in SR (HR 8.08; 95 % CI 4.02-16.26; p < 0.0001), but not in AF patients (HR 1.97; 95 % CI 0.91-4.28; p = 0.087) with a significant interaction between the rhythms. By contrast, low-peak VO2 was independently associated with HF events in both rhythms (AF; HR 5.81; 95 % CI 1.75-19.30; p = 0.004, SR; HR 2.04; 95 % CI 1.19-3.49; p = 0.009), with a marginal interaction between them. In bivariate Cox models, low-peak VO2 had much stronger predictive power for HF events than high-BNP in AF, whereas high-BNP was more powerful than low-peak VO2 in SR. The prognostic value of BNP and peak VO2 for future HF events seemed to be different between SR and AF.
Asunto(s)
Arritmia Sinusal/complicaciones , Fibrilación Atrial/complicaciones , Insuficiencia Cardíaca/sangre , Péptido Natriurético Encefálico/sangre , Consumo de Oxígeno , Anciano , Prueba de Esfuerzo , Femenino , Insuficiencia Cardíaca/fisiopatología , Humanos , Japón , Modelos Lineales , Masculino , Persona de Mediana Edad , Análisis Multivariante , Pronóstico , Modelos de Riesgos Proporcionales , Volumen SistólicoRESUMEN
O manejo de dispositivos cardíacos eletrônicos implantáveis em portadores de arritmias atriais ou outras condições que demandem uso crônico de anticoagulante oral sempre gerou grande conflito nas cirurgias. Este trabalho traz a experiência da realização de intervenções com dispositivos cardíacos eletrônicos implantáveis em serviço especializado em arritmias cardíacas, apresentando resultados similares aos da literatura e que devem mudar paradigmas. Método: Realizamos intervenções desde implante de marcapassos monocamerais até upgrade para marcapassos/ cardiodesfibriladores multissítio em usuários de anticoagulantes orais, incluindo varfarina e os novos anticoagulantes orais ou de ação direta (dabigatrana, rivaroxabana e apixabana). As intervenções foram realizadas por médicos experientes e todos os pacientes foram reexaminados 15 dias após a cirurgia para retirada dos pontos e revisão clínica e do dispositivo. Resultados: Os procedimentos foramrealizados em 20 pacientes, em 5 dos quais foi mantido o uso de anticoagulantes de ação direta. A ocorrência de hematoma na loja se deu em 3 pacientes (INR de 3,4 e 2,63 e outro com apixabana) e todos tiveram boa evolução após conduta expectante sem retirada do anticoagulante oral, com reabsorção completa 30 dias depois.Naqueles em uso de varfarina, o INR médio foi de 2,85, sendo o menor de 2 e o maior, de 4,14. Em nossa série decasos conseguimos reproduzir dados do estudo BRUISE, que demonstrou diferença significativa na ocorrência dehematoma quando se adotou estratégia de intervenção realizando ponte com heparina. Em nossa série, 3 pacientesapresentaram hematoma, sem necessidade de intervenção (somente acompanhamento clínico) e sem aumentar o tempo de internação. Nossa série de casos incluiu os anticoagulantes de ação direta disponíveis no mercado.Conclusão: Este trabalho traz dados similares aos dos grandes estudos...
The management of implantable electronic cardiac devices in patients with atrial arrhythmias or other conditions that require the chronic use of oral anticoagulants has always generated great controversy in surgery. This study reports the experience of performing interventions with implantable electronic cardiac devices in specialized cardiac arrhythmia services with similar results to literature data, which must surely change paradigms. Method: We performed interventions ranging from single-chamber pacemaker implant to upgrade to multisite pacemakers/cardiodefibrillator in patients receiving oral anticoagulants including warfarin and the new oral or direct action anticoagulants (dabigatran, rivaroxaban and apixaban). Experienced surgeons performed the interventions. All of the patients were reexamined 15 days after the surgery to remove stiches,for clinical and device evaluation. Results: We performed procedures in 20 patients; in 5 of them direct oralanticoagulants were maintained. Significant hematomas were observed in 3 patients (INR of 3.4 and 2.63 andanother with apixaban), and all of them had good outcomes after a watchful waiting while maintaining the oralanticoagulant, with complete reabsorption after thirty days. In patients receiving warfarin, mean INR was 2.85, the lowest was 2.0 and the highest 4.14. In our series of cases we reproduced data from BRUISE study, which showed a significant difference in the occurrence of hematoma when the intervention strategy included a bridgewith heparin. In our series, 3 patients had hematoma, but did not require an intervention (only clinical follow-up)and there was no increase in the length of stay. We used direct action anticoagulants available in the market.Conclusion: Our study provides similar data to major studies...
Asunto(s)
Humanos , Masculino , Femenino , Persona de Mediana Edad , Anciano de 80 o más Años , Anticoagulantes/administración & dosificación , Arritmia Sinusal/complicaciones , Dispositivos de Terapia de Resincronización Cardíaca , Marcapaso Artificial , Hematoma/complicaciones , Heparina/administración & dosificación , Inhibidores de Factor de Coagulación Sanguínea/administración & dosificación , Warfarina/administración & dosificaciónRESUMEN
Oculopharyngeal muscular dystrophy is a rare genetic disease manifesting after 45years old, affecting the levator muscles of eyelids and muscles of swallowing. We report the first case of a patient of 73years old suffering from an oculopharyngeal muscular dystrophy hospitalized for syncope, a complication of severe sinus dysfunction, requiring the implantation of a pacemaker.
Asunto(s)
Arritmia Sinusal/complicaciones , Distrofia Muscular Oculofaríngea/complicaciones , Anciano , Humanos , Masculino , Marcapaso Artificial , Síncope/etiología , SíndromeRESUMEN
Stroke is the leading cause of disability worldwide. It is known that atrial fibrillation and left atrial enlargement contribute ischemic stroke, and mean platelet volume (MPV) increases in patients with ischemic stroke and atrial fibrillation. We aimed to determine whether higher MPV is associated with ischemic stroke in patients with sinus rhythm. We evaluated 74 patients in sinus rhythm and with ischemic stroke (Group 1) and 90 age-matched and sex-matched healthy individuals as control group (Group 2). After physical and echocardiographic examination, 24-48âh Holter monitoring and complete blood counts were studied. There were no statistically significant differences in age, sex rates, and comorbidities between groups. Left atrial diameter was higher in Group 1 than Group 2 (Pâ=â0.001), but both were in normal range. MPV was significantly higher in Group 1 (Pâ<â0.001) and was an independent determinant [odds ratio (OR): 1.840; Pâ<â0.001; 95% confidence interval (CI) 1.330-2.545] of ischemic stroke with left atrial (OR: 1.138; Pâ=â0.006; 95% CI 1.037-1.248). In conclusion, higher MPV is associated with acute ischemic stroke in patients with sinus rhythm and without heart failure or left atrial enlargement. MPV and left atrial diameter are independent predictors of ischemic stroke in this patient population.
Asunto(s)
Arritmia Sinusal/diagnóstico , Fibrilación Atrial/diagnóstico , Plaquetas/patología , Cardiomegalia/diagnóstico , Accidente Cerebrovascular/diagnóstico , Anciano , Arritmia Sinusal/sangre , Arritmia Sinusal/complicaciones , Fibrilación Atrial/sangre , Fibrilación Atrial/complicaciones , Biomarcadores/sangre , Cardiomegalia/sangre , Cardiomegalia/complicaciones , Estudios de Casos y Controles , Femenino , Atrios Cardíacos/metabolismo , Atrios Cardíacos/patología , Humanos , Masculino , Volúmen Plaquetario Medio , Persona de Mediana Edad , Accidente Cerebrovascular/sangre , Accidente Cerebrovascular/complicacionesRESUMEN
A 54-year-old woman was referred to our hospital for symptomatic sinus bradyarrhythmia with a sinus pause of 8 seconds. She was diagnosed with dextrocardia during childhood and discovered to have heterotaxy syndrome when she had an appendectomy during her teenager years. Chest and abdominal examinations by computed tomography showed multiple spleens located on the right side and abnormal drainages of the superior and inferior vena cava. Left isomerism was diagnosed by bilaterally bilobed lungs. Because of a patent bilateral superior vena cava, pacemaker leads were implanted using the right cephalic vein approach. Her fainting symptoms disappeared after pacemaker implantation.
Asunto(s)
Arritmia Sinusal/fisiopatología , Dextrocardia/fisiopatología , Síndrome de Heterotaxia/diagnóstico por imagen , Marcapaso Artificial , Síncope/fisiopatología , Arritmia Sinusal/complicaciones , Dextrocardia/complicaciones , Dextrocardia/terapia , Femenino , Síndrome de Heterotaxia/fisiopatología , Síndrome de Heterotaxia/terapia , Humanos , Persona de Mediana Edad , Síncope/etiología , Síncope/terapia , Tomografía Computarizada por Rayos X , Vena Cava Inferior/anomalíasRESUMEN
BACKGROUND: Atrial fibrillation (AF) is a major risk factor for stroke. Cost-effectiveness studies of anticoagulants for stroke prevention in AF rarely utilise AF-stroke-specific cost data in their analyses, as data are limited. Data that exist do not account for AF found on prolonged cardiac monitoring after stroke, further underestimating the clinical and economic burden of AF-stroke. OBJECTIVE: Our objective was to investigate differences in direct medical costs of acute stroke care among patients with and without AF. METHODS: Data were prospectively collected from 213 consecutive patients with confirmed stroke (196 ischaemic [IS], 17 intracranial haemorrhage [ICH]), admitted to a UK district general hospital between November 2011 and October 2012. Sociodemographic, clinical and cardiac monitoring characteristics were recorded, and resource use was calculated using a 'bottom-up' approach. Univariate and multivariate stepwise regressions were performed to identify predictors of direct cost. RESULTS: Among patients with IS, 73 had AF (37%). These patients were older, experienced greater stroke severity, lengths of hospitalisation, inpatient mortality and discharge to institutionalised care than those without AF. Mean acute care costs for the year 2012 were £6,978 (standard deviation [SD] 6,769, range 510-36,952). Mean (SD) costs were significantly higher for patients with AF than for those without (£9,083 [7,381] vs. £5,729 [6,071], p = <0.001). AF independently predicted acute care cost along with history of heart failure and stroke severity. The adjusted independent effect of having AF on costs was an additional £2,173 (95% confidence interval 91-4,254; p = 0.041). Costs for patients with an ICH did not differ according to cardiac rhythm. CONCLUSION: Direct medical costs of acute stroke care for patients with AF may be 50% greater than for patients without. Economic studies should take this into account to ensure the benefits of anticoagulants are not underestimated.
Asunto(s)
Anticoagulantes/economía , Arritmia Sinusal/economía , Fibrilación Atrial/economía , Costos Directos de Servicios , Accidente Cerebrovascular/economía , Anciano , Anciano de 80 o más Años , Anticoagulantes/administración & dosificación , Anticoagulantes/uso terapéutico , Arritmia Sinusal/sangre , Arritmia Sinusal/complicaciones , Arritmia Sinusal/tratamiento farmacológico , Fibrilación Atrial/sangre , Fibrilación Atrial/complicaciones , Fibrilación Atrial/tratamiento farmacológico , Femenino , Humanos , Masculino , Análisis Multivariante , Análisis de Regresión , Índice de Severidad de la Enfermedad , Accidente Cerebrovascular/sangre , Accidente Cerebrovascular/etiología , Accidente Cerebrovascular/prevención & controlAsunto(s)
Humanos , Femenino , Persona de Mediana Edad , Síndrome de Brugada/complicaciones , Síndrome de Brugada/diagnóstico , Síndrome de Brugada/etiología , Fiebre/complicaciones , Fiebre/etiología , Diagnóstico Precoz , Síndrome de Brugada/fisiopatología , Síndrome de Brugada/terapia , Síndrome de Brugada , Atención Primaria de Salud/métodos , Arritmia Sinusal/complicaciones , Arritmia Sinusal , Taquicardia Sinusal/complicaciones , Taquicardia SinusalAsunto(s)
Humanos , Masculino , Persona de Mediana Edad , Intoxicación Alcohólica/complicaciones , Intoxicación Alcohólica , Arritmias Cardíacas/complicaciones , Arritmias Cardíacas , Ecocardiografía/métodos , Ecocardiografía , Hipertrofia/complicaciones , Hipertrofia , Cardiomiopatía Hipertrófica/complicaciones , Cardiomiopatía Hipertrófica , Delirio por Abstinencia Alcohólica/complicaciones , Delirio por Abstinencia Alcohólica , Radiografía Torácica/métodos , Radiografía Torácica , Arritmia Sinusal/complicaciones , Arritmia Sinusal , Fibrilación Atrial/complicaciones , Fibrilación AtrialRESUMEN
Continuamos con la serie de casos clínicos en Cardiología pediátrica presentados de forma breve y práctica y tratando de mostrar la utilidad del electrocardiograma, método diagnóstico del que disponemos en Atención Primaria. En este número se presenta el caso de un recién nacido con arritmia en el periodo perinatal. Se discuten los hallazgos electrocardiográficos y la orientación en el manejo de este paciente (AU)
We continue the series of clinical cases in Pediatric Cardiology. They are presented briefly and practically and trying to show the usefulness of the electrocardiogram, diagnostic method available in primary care. In this issue we present the case of a newborn with arrhythmia in the perinatal period. Electrocardiographic findings and guidance in the management of this patient are discussed (AU)
Asunto(s)
Humanos , Masculino , Recién Nacido , Arritmias Cardíacas/complicaciones , Arritmias Cardíacas/diagnóstico , Arritmia Sinusal/complicaciones , Arritmia Sinusal/diagnóstico , Taquicardia Supraventricular/complicaciones , Taquicardia Supraventricular , Electrocardiografía/métodos , Electrocardiografía , Arritmias Cardíacas/fisiopatología , Arritmias Cardíacas , Arritmia Sinusal , Ecocardiografía Doppler/instrumentación , Ecocardiografía Doppler/métodosAsunto(s)
Humanos , Masculino , Anciano de 80 o más Años , Hernia Hiatal/complicaciones , Hernia Hiatal/diagnóstico , Choque/complicaciones , Choque/diagnóstico , Dolor en el Pecho/complicaciones , Dolor en el Pecho/etiología , Radiografía Torácica/tendencias , Radiografía Torácica , Fístula del Sistema Digestivo/complicaciones , Fístula del Sistema Digestivo , Hernia Hiatal/fisiopatología , Hernia Hiatal , Electrocardiografía , Arritmia Sinusal/complicaciones , Taquicardia Sinusal/complicaciones , Taquicardia Sinusal/diagnóstico , Taquicardia Sinusal/fisiopatología , Aorta Torácica/patología , Aorta TorácicaAsunto(s)
Humanos , Masculino , Femenino , Electrocardiografía/instrumentación , Electrocardiografía/métodos , Electrocardiografía , Arritmias Cardíacas , Arritmia Sinusal/complicaciones , Arritmia Sinusal/fisiopatología , Arritmia Sinusal , Frecuencia Cardíaca , Frecuencia Cardíaca/fisiología , Frecuencia Cardíaca/efectos de la radiaciónRESUMEN
Polyvagal theory has influenced research on the role of cardiac vagal control, indexed by respiratory sinus arrhythmia withdrawal (RSA-W) during challenging states, in children's self-regulation. However, it remains unclear how well RSA-W predicts adaptive functioning (AF) outcomes and whether certain caveats of measuring RSA (e.g., respiration) significantly impact these associations. A meta-analysis of 44 studies (n=4996 children) revealed small effect sizes such that greater levels of RSA-W were related to fewer externalizing, internalizing, and cognitive/academic problems. In contrast, RSA-W was differentially related to children's social problems according to sample type (community vs. clinical/at-risk). The relations between RSA-W and children's AF outcomes were stronger among studies that co-varied baseline RSA and in Caucasian children (no effect was found for respiration). Children from clinical/at-risk samples displayed lower levels of baseline RSA and RSA-W compared to children from community samples. Theoretical/practical implications for the study of cardiac vagal control are discussed.