Takotsubo cardiomyopathy: assessment with cardiac MRI.

OBJECTIVE: The objective of this article is to show how MRI findings can be used to differentiate Takotsubo cardiomyopathy from acute coronary syndrome. CONCLUSION: Takotsubo cardiomyopathy is a disorder that mimics acute coronary syndrome. MRI can show not only edema in the ventricular wall, which is diffuse and without arterial territory distribution, but also motion abnormalities with typical akinesis in the apical and mid planes. Moreover, MRI can detect potential complications such as obstruction of the left ventricular outflow tract or thrombus in the left ventricular cavity.

Left ventricular apical diseases.

There are many disorders that may involve the left ventricular (LV) apex; however, they are sometimes difficult to differentiate. In this setting cardiac imaging methods can provide the clue to obtaining the diagnosis. The purpose of this review is to illustrate the spectrum of diseases that most frequently affect the apex of the LV including Tako-Tsubo cardiomyopathy, LV aneurysms and pseudoaneurysms, apical diverticula, apical ventricular remodelling, apical hypertrophic cardiomyopathy, LV non-compaction, arrhythmogenic right ventricular dysplasia with LV involvement and LV false tendons, with an emphasis on the diagnostic criteria and imaging features. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s13244-011-0091-6) contains supplementary material, which is available to authorized users.

Radiologic findings of segmental testicular infarction.

OBJECTIVE: Our objective was to describe the radiologic findings of segmental testicular infarction and to establish a proper diagnosis that can avoid orchiectomy. CONCLUSION: The presence of a triangular-shaped avascular intratesticular lesion on sonography or MRI and enhancement of the surrounding borders on enhanced MR images may suggest a presurgical diagnosis of segmental testicular infarction and therefore avoid a total orchiectomy in these patients.

[Attitude of the health care professionals toward hypertension in the health service area of Salamanca]. / Actitudes de los profesionales de atención primaria ante la hipertensión en el área de salud de Salamanca.

A survey was carried out in the ten Health Centers in Salamanca using a questionnaire about aspects related with hypertension, the material used, diagnostic methods, risk factors, therapeutic approach, and management of hypertensive paroxysms and emergencies. Participation was 59.5% and the median age 36 years. There was a definite male predominance (85.3%). The use of three blood pressure readings in successive visits for the diagnosis was preferred by the professionals with younger working age [Cl = 8.8 to 12.8 years; (p less than 0.05)]. Regarding the type of Center (rural, urban, semiurban), significant differences regarding the investigated issues could not be established. The most relevant conclusions were deficiencies such as inadequacy of cuffs (53.3%), lack of calibration of sphygmomanometers (41.9%), introduction of thestethoscope within the cuff (34.7%), use of beta-blockers in hypertensive diabetics (13.5%).

Tomografía computarizada multidetectora en el estudio cardíaco / Cardiac imaging in multidetector row computed tomography

La aparición de la tomografía computarizada (TC) helicoidal en la década de los años noventa supuso el salto tecnológico para obtener imágenes en distintos planos del espacio. Esto se debió a la adquisición volumétrica, es decir, el tubo de rayos X mantenía la exposición mientras la mesa se movía de forma continua. La posibilidad de aumentar el número de detectores favorecía la rapidez al obtener varias imágenes (4, 16, 40 o 64) en cada giro del tubo. Así se estudia un volumen (tórax o abdomen) con mejor resolución espacial e imágenes muy finas: 0,5 mm. La resolución temporal, que es el tiempo para obtener una imagen, mejoró significativamente debido a la mayor velocidad en el giro del tubo. Sin embargo, en el estudio del corazón se precisa también la sincronización con el ciclo cardíaco para adquirir las imágenes en la zona telediastólica, lo que posibilita no sólo la visualización de las arterias coronarias, sino también la valoración de los bypass, stents, anomalías coronarias e incluso el estudio de la función ventricular (AU)

Helical computed tomography (CT) emerged during the 1990s and represented an advance in CT technology, allowing images to be visualized in different planes. This was due to volumetric acquisition, i.e. the X-ray tube is active while the table is moving into the gantry. The possibility of increasing the number of detectors allowed the procedure to be performed more rapidly as several images could be obtained in each tube rotation (4, 16, 40 or 64). Thus, volume (thorax or abdomen) could be studied with better spatial resolution and images of as little as 0.5mm of collimation. Temporal resolution, defined as the time required to obtain an image, markedly improved due to faster tube rotation. However, in cardiac evaluation, synchronization with the cardiac phase was required to acquire images in telediastole, allowing not only visualization of the coronary arteries but also evaluation of coronary artery bypass grafts, stents, coronary anomalies, and even ventricular function (AU)