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On September 20, 2017, Hurricane Maria hit Puerto Rico, causing an unprecedented humanitarian crisis on a level that none of us have experienced before. The following editorial intends to show a physician's perspective of the impact of this storm on healthcare, particularly in triggering cardiovascular events.
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BACKGROUND: A limited number of studies have been published about coronary artery disease in Hispanics, particularly among the Puerto Rican population. The aim of this study was to present a clinical epidemiological profile and management practices in patients hospitalized in Puerto Rico with acute myocardial infarction (AMI). METHODS: This secondary data analysis from the Puerto Rico Cardiovascular Surveillance Study included 6,162 patients at 19 hospitals in Puerto Rico, during years 2007, 2009 and 2011. RESULTS: The mean age of the patients diagnosed with AMI was 67 ± 13.6 years old, with women being older than men (P < 0.001). Women had a different risk factor burden when compared to men. Car/walked in was the principal mode of hospital transportation (65.9%). Women received less medications and cardiac procedures when compared to men. While no significant differences in length of hospital stay (LOS) were observed between genders, in-hospital mortality rate was higher in females when compared with males (6.5% vs. 4.5%; P < 0.001). CONCLUSION: Prompt initiatives should be implemented to raise awareness, reduce gender disparities and improve outcomes in patients hospitalized with an AMI in Puerto Rico.
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OBJECTIVE: Peripartum cardiomyopathy is a rare type of heart failure to which only pregnant women are susceptible. In Puerto Rico there is a paucity of information regarding this condition. In this report we describe our experience with peripartum cardiomyopathy. METHODS: This was a descriptive retrospective study. We conducted a chart review of all the patients with peripartum cardiomyopathy managed at our institution from January 2006 through December 2012. A total of 12 patients qualified for our analysis. RESULTS: The mean age of our population was 27 (± 8) years. Eight of the twelve (67%) patients were multigravid women, with a mean parity of 2.6 (± 1.6). Most patients (75%) showed clinical evidence of anemia while pregnant, and more than half (58%) delivered prematurely. Six patients (50%) had a prior history of preeclampsia. Cardiac imaging detected a mean ejection fraction of 35% (± 8%) at the time of diagnosis. Only 1 maternal death was documented. CONCLUSION: Our study cohort was very similar to those in most case series in which the same condition has been studied. In order to better understand the pathophysiology of this entity and, thus, improve treatment for these patients, prospective studies are needed.
