Diabetes y alteraciones motoras / Diabetes and motor impairments

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Comunicación intraventicular en un paciente adulto / Ventricular septal defect in an adult patient

Presentamos el caso clínico de un varón asintomático de 46 años en cuya radiografía de tórax se observa un botón aórtico derecho y en la exploración física un soplo sistólico con frémito palpable paraesternal izquierdo. Al realizársele ecocardiografía transesofágica y RMN se encontró una comunicación interventricular (CIV) que únicamente precisa revisiones ecocardiográficas periódicas. La CIV es la cardiopatía congénita más frecuente. Las CIV pueden ser membranosas, de entrada, trabeculadas o infundibulares. La sintomatología puede ser desde anodina únicamente con un soplo pansistólico paraesternal izquierdo en la exploración física, hasta hiperaflujo pulmonar que llegue a causar insuficiencia cardiaca. La radiografía de tórax mostrará cardiomegalia, el electrocardiograma hipertrofia biventricular y la ecocardiografía y la resonancia magnética mostrarán tamaño y número de comunicaciones. El tratamiento es conservador, ya que el 50% se cierran de forma espontánea en los primeros años de vida, reservando la cirugía para los casos sintomáticos y los asintomáticos con cortocircuito significativo (AU)

We report the case of a 46 year old asymptomatic male whose chest X-ray showed a right aortic knob and in the physical examination he had a systolic murmur with a palpable left parasternal heave. On performing the transesophageal echocardiography and MRI a ventricular septal defect (VSD) was observed which only requires periodic echocardiographic reviews. VSD is the most common congenital heart disease. The VSD may be membranous, inlet, trabecular, or infundibular. The clinical signs may range from only anodyne with a left pansystolic parasternal murmur on physical examination, up to lung hyper-flow which may lead to heart failure. The chest X-ray showed cardiomegaly, the electrocardiogram showed biventricular hypertrophy, and the echocardiography and MRI showed the size and number of communications. Treatment is conservative, since 50% close spontaneously in the first years of life, reserving surgery for symptomatic and asymptomatic cases with a significant shunt (AU)

[Ventricular septal defect in an adult patient]. / Comunicación intraventicular en un paciente adulto.

We report the case of a 46 year old asymptomatic male whose chest X-ray showed a right aortic knob and in the physical examination he had a systolic murmur with a palpable left parasternal heave. On performing the transesophageal echocardiography and MRI a ventricular septal defect (VSD) was observed which only requires periodic echocardiographic reviews. VSD is the most common congenital heart disease. The VSD may be membranous, inlet, trabecular, or infundibular. The clinical signs may range from only anodyne with a left pansystolic parasternal murmur on physical examination, up to lung hyper-flow which may lead to heart failure. The chest X-ray showed cardiomegaly, the electrocardiogram showed biventricular hypertrophy, and the echocardiography and MRI showed the size and number of communications. Treatment is conservative, since 50% close spontaneously in the first years of life, reserving surgery for symptomatic and asymptomatic cases with a significant shunt.

Neumomediastino espontáneo primario / No disponible

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