Diagnostico prenatal de las cardiopatias congenitas / Prenatal diagnosis of congenital cardiopathy

Fetal echocardiography can be performed as early as the 16th week gestation and with improved equipment all forms of congenital heart diseases can be detected in utero. In this article we discuss the indications for a fetal heart echocardiography and the techniques used in a fetal heart examination and review the structural and functional information that can be obtained.

[Prenatal diagnosis of congenital cardiopathy]. / Diagnostico prenatal de las cardiopatias congenitas.

Fetal echocardiography can be performed as early as the 16th week gestation and with improved equipment all forms of congenital heart diseases can be detected in utero. In this article we discuss the indications for a fetal heart echocardiography and the techniques used in a fetal heart examination and review the structural and functional information that can be obtained.

[Clinical, electrocardiographic and angiographic evaluation of natural reservoirs of Chagas' disease in the Republic of Panama]. / Evaluacion clinica, electrocardiografica y angiografica de los reservorios naturales de la enfermedad de chagas en la Republica de Panama.

The authors studied two groups of natural animal reservoirs for Trypanosoma cruzi: a wild one, the common rat Rattus rattus and the house dog, Canis canis. Thirty one naturally infected rats were evaluated with a technique developed by the authors which allows the recording of the ECG and the performance of a ventricular angiogram without altering the functional capacity of the animal. Forty four dogs were followed clinically for a period of twenty years to study the development of the cardiac lesion seen in the chronic phase of the disease. The authors demonstrate the epidemiologic importance of the dog as a reservoir and the ease with which the infection can be acquired from rats, which live in the same habitat with human patients. The most common lesions in both groups were ventricular and atrial arrhythmias and second degree AV block; and, in the dogs, also death due to refractory cardiac failure, such as is seen in the human patient. Right bundle branch block and dilatation of the right cardiac chambers was the rule in both groups. The authors discuss the pathogenesis of the ECG in the rat and its anatomical basis. They propose the possibility of establishing and standardizing this techniques in the laboratories that study rats or other species.

Evaluacion clinica, electrocardiografica y angiografica de los reservorios naturales de la enfermedad de chagas en la Republica de Panama / Clinical, electrocardiographic and angiographic evaluation of natural reservoirs of Chagas' disease in the Republic of Panama

The authors studied two groups of natural animal reservoirs for Trypanosoma cruzi: a wild one, the common rat Rattus rattus and the house dog, Canis canis. Thirty one naturally infected rats were evaluated with a technique developed by the authors which allows the recording of the ECG and the performance of a ventricular angiogram without altering the functional capacity of the animal. Forty four dogs were followed clinically for a period of twenty years to study the development of the cardiac lesion seen in the chronic phase of the disease. The authors demonstrate the epidemiologic importance of the dog as a reservoir and the ease with which the infection can be acquired from rats, which live in the same habitat with human patients. The most common lesions in both groups were ventricular and atrial arrhythmias and second degree AV block; and, in the dogs, also death due to refractory cardiac failure, such as is seen in the human patient. Right bundle branch block and dilatation of the right cardiac chambers was the rule in both groups. The authors discuss the pathogenesis of the ECG in the rat and its anatomical basis. They propose the possibility of establishing and standardizing this techniques in the laboratories that study rats or other species

[Arterial hypertension in children]. / Hipertensión arterial en niños.

Arterial hypertension is the main cause of cardiovascular problems in adults. To better know the scope of arterial hypertension in children in our midst, the authors measured the arterial blood pressure in 8642 Panamanian children between 1 month and 18 years of age and studied the principal causes of arterial hypertension. The authors propose norms for the identification and clinical and pharmacological management of arterial hypertension in Panamanian children.

Hipertensión arterial en niños / Arterial hypertension in children

Arterial hypertension is the main cause of cardiovascular problems in adults. To better know the scope of arterial hypertension in children in our midst, the authors measured the arterial blood pressure in 8642 Panamanian children between 1 month and 18 years of age and studied the principal causes of arterial hypertension. The authors propose norms for the identification and clinical and pharmacological management of arterial hypertension in Panamanian children

[Fetal cardiocirculatory physiology]. / Fisiología cardiocirculatoria fetal.

The authors analyzed the physiology of fetal circulation and its variations during hypoxia. They propose a systematic approach which would allow early diagnosis of hypoxia during its initial phases, as a contribution in order to reduce perinatal morbidity and mortality.

[Echocardiographic assessment of patients with sickle cell anemia]. / Evaluación ecocardiográfica de pacientes con anemia falciforme.

One hundred and sixty four (164) patients were evaluated. Sixty (60) with Sickle cell disease (SSHg.) and ninety seven (97) with Trait (ASHg.); seventeen (17) were normal control group. The study confirmed that the incidence of cardiomyopathy in Trait (ASHg.) is greater than reported by other clinical investigations. Cardiac arrhythmia, atrial fibrillation, premature ventricular contractions, bundle branch blocks, and T and ST modifications with sub epicardial isquemia were most significant electrocardiographics changes. The possibility of myocardial infarction in SS patients with low or normal hemoglobin is significant. M-Mode and 2-D echo, demonstrated similar end diastolic volumes in AS and SS patients in which cardiomyopathy were diagnosticated. Patients with cardiac failure, treated with cardiotonics, diuretics and ACE were compensated most frequently. To prevent hemosiderosis, antioxydant (alfatocoferol and Ubiquinones) were used with satisfactory response.

[Flow in the umbilical cord in normal and high-risk pregnancies]. / Flujo en la vena umbilical en embarazos normales y en los de alto riesgo.

The author studied umbilical venous blood flow in 100 normal pregnant women and in 100 pregnant women with apparent delay in intrauterine growth (DIUG). At birth, it was shown that only 50 babies had DIUG and that the blood flow was low in 49. In the other 50 babies there was no DIUG and blood flow in the umbilical vein was normal in all of them. The same study was carried out in 50 pregnant women with fetal hypoxia due to placental pathology (32), hemorrhage in the third trimester (15) and Rh isoimmunization (3). This study showed that increased blood flow in the umbilical vein is an early and sure sign of hypoxia due to placental pathology, hemorrhage in the last three months of gestation or Rh isoimmunization. It was also ascertained that low umbilical venous blood flow is a bad prognostic sign because it indicates that the fetus receives an abnormally low quantity of originated blood from the placenta, as was the case of the fetus with DIUG or in the final stages of hypoxia, and that when this happens, the fetus is already incapable of controlling the compensatory circulatory mechanisms and is at imminent risk of cardiac damage.