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Kounis syndrome (KS) was first described in 1991 by Kounis and Zavras and is also known as allergic angina syndrome or allergy myocardial infarction. It is a rare, and frequently undiagnosed syndrome that is characterized by an anaphylactic reaction. Allergens cause massive degranulation of mast cells leading to coronary spasm, microvascular angina, and/or endothelial dysfunction with myocardial infarction. The annual incidence of severe, life-threatening anaphylaxis with circulatory symptoms is about 7.9-9.6 cases per 100,000 people. More than 300 cases of KS have been described after exposure to various agents such as drugs, insect venoms, food, or medicated stents. Although the incidence of KS is very low, the incidence of myocardial infarction due to anaphylaxis secondary to gadolinium is even lower, reported in a range of 0.002-0.01%. The objective of this article is to review the current data on KS, regarding a case of allergy to gadolinium, which has an extremely low incidence. [ABSTRACT FROM AUTHOR]

Introducción: La interpretación del electrocardiograma es crucial en el diagnóstico del infarto de miocardio y las arritmias ventriculares y supraventriculares, enfermedades que representan importantes emergencias médicas. Objetivo: Determinar el nivel de competencias en la interpretación del electrocardiograma en estudiantes de medicina humana. Métodos: Estudio observacional, descriptivo, transversal. Se encuestó un total de 180 estudiantes de medicina. El instrumento de estudio contenía un total de 20 ítems, los cuales se agruparon en 3 dimensiones; competencias básicas en electrocardiografía, competencias en el reconocimiento del infarto de miocardio y competencias en el reconocimiento de las arritmias. Asimismo, se evaluaron las variables sociodemográficas, edad, género, poseer una segunda carrera de salud, llevar cursos extracurriculares en electrocardiografía y el registro histórico de asignaturas reprobadas. Se aplicó estadística descriptiva y la prueba ji cuadrado para asociaciones. Resultados: De los 180 estudiantes se obtuvo una mediana y el rango intercuartílico de la evaluación fue de 9 ± 5, a su vez las dimensiones de competencias básicas en electrocardiograma, infarto de miocardio y arritmias, registraron valores de 3 ± 2,75, 3 ± 2,00 y 3 ± 2,10 puntos respectivamente. La frecuencia de aprobados fue de 64 (35,6 %); las variables de capacitación extracurricular (p-valor = 0,021) y segunda profesión en salud (p-valor = 0,003) presentaron una asociación estadísticamente significativa respecto al nivel de conocimiento en electrocardiografía. Conclusiones: El nivel de competencias en la interpretación de los electrocardiogramas de los estudiantes puede ser inadecuado cuando no han realizado capacitaciones extracurriculares o segundas carreras profesionales en salud.

Fundamento: pese a la importancia del primer evento de fibrilación auricular como una de las urgencias médicas más tratadas, en Cienfuegos, son insuficientes los estudios en los que se describan las características clínico-epidemiológicas de estos pacientes. Objetivo: caracterizar clínica y epidemiológicamente los pacientes con primer evento de fibrilación auricular en Cienfuegos entre los años 2020-2022. Método: se realizó un estudio descriptivo y transversal. El universo estuvo conformado por 54 pacientes con diagnóstico de primer evento de fibrilación auricular ingresados en el Servicio de Cardiología del Hospital General Universitario Dr. Gustavo Aldereguía Lima de Cienfuegos entre los años 2020-2022. Las variables estudiadas fueron: edad, sexo, color de la piel, hábitos tóxicos, antecedentes patológicos personales, manifestaciones clínicas, parámetros ecocardiográficos y tratamiento. Se calcularon la frecuencia absoluta y relativa de las variables. Los resultados se presentaron en tablas. Resultados: predominó el sexo masculino, el grupo etáreo de 36-55 años, el color de piel blanca, y el tabaquismo. Los antecedentes patológicos personales más frecuentes fueron: la hipertensión arterial (74,1 %), la diabetes mellitus tipo 2 (16,7 %) y las valvulopatías (11,1 %). Las manifestaciones clínicas más frecuentes fueron: las palpitaciones (77,8 %), seguidas de la disnea (12,9 %). Los parámetros ecocardiográficos estuvieron en el rango de la normalidad. El tratamiento farmacológico se aplicó al 68,5 % seguido de cardioversión farmacológica y eléctrica en el 16,7 %. Conclusiones: el mayor número de pacientes con primer evento de fibrilación auricular, tienen un corazón estructuralmente sano, por lo que se considera de vital importancia la prevención de recurrencias, esto evitará la creación de condiciones eléctricas y anatómicas que perpetúen la arritmia.

Background: There is no national registry on dyslipidemia and low-density lipoprotein cholesterol (LDL-c) goals by risk groups for atherosclerotic cardiovascular disease (ACVD) focused on beneficiaries of the Mexican Institute for Social Security (IMSS). Objective: To determine the frequency of dyslipidemia, LDL-c goals and patients in treatment from high and very high-risk groups of ACVD. Material and methods: Multicenter, cross-sectional, descriptive study. This article derives from the Mexican Registry of Dyslipidemias in patients at high-risk and very high-risk of atherosclerotic cardiovascular disease (REMEXDIS-IMSS Project). Patients with high-risk and very high-risk criteria for ACVD were included. Results: From July 2022 to March 2023, 6000 patients were included (3289 patients in the high-risk group and 2771 in the very high-risk group). The frequency of dyslipidemia was observed in 49% of the cohort. The very high-risk group presented a higher percentage of dyslipidemia in 66.8%, acute myocardial infarction in 81.0% and angina pectoris in 21.9%. The use of statins was higher in this group (93.3%) and the LDL-c goal was achieved in 72.9% (p < 0.0001). Conclusions: The frequency of dyslipidemia was found in almost half of the population. The very high-risk group had a higher frequency of dyslipidemia, better use of statins for indication of secondary prevention, and a greater number of patients with LDL-c goals compared to the high-risk group. [ABSTRACT FROM AUTHOR]

Background: Mexico is the country with the highest mortality from acute myocardial infarction (AMI), which is why guidelines have been established for early reperfusion in which fibrinolysis is the second most accessible method. However, there is a percentage of patients who do not achieve acceptable myocardial perfusion and this is associated with adverse cardiovascular outcomes. Different adenosine schemes have been used as an adjuvant to restore adequate myocardial perfusion. Objective: To compare the final angiographic flow in patients undergoing pharmacoinvasive percutaneous coronary intervention (PCI) with the use of intracoronary adenosine versus patients without its use. Material and methods: Single-center, prospective, longitudinal, single-blind study carried out in patients with AMI, thrombolyzed, with reperfusion data, sent to a tertiary care center from March 2022 to June 2023, randomized to receive intracoronary adenosine previous to intervention. Drugeluting stents were placed in all patients. Initial and final angiographic flow was compared. Results: 33 patients were included, randomized 1:1 to control and intervention groups. 75.8% of the participants were male. The most frequent artery responsible for the infarction was the anterior descending (63.6%). An average of 350 mcg of intracoronary adenosine was used in the intervention group, and the most frequent complication in both groups was the presence of no-reflow phenomenon. Conclusions: Due to the small sample size, it is not possible to conclude the usefulness of adenosine for improving final angiographic flow in pharmacoinvasive PCI. More adverse effects were reported in the intervention group, without a significant statistical difference. [ABSTRACT FROM AUTHOR]

Objective: To identify the risk factors based on clinical, echocardiographic and therapeutic parameters which predict the development of cardiac complications among patients with diabetes and acute myocardial infarction (AMI). Materials and methods: An observational, analytical, case-control study was conducted at Centro de Cardiología y Cirugía Cardiovascular de Santiago de Cuba, attached to Hospital Provincial Saturnino Lora, from 2019 to 2021. The sample consisted of 266 patients, chosen by simple random sampling 1:2. The study included demographic, clinical- echocardiographic and therapeutic variables. A multivariate analysis was performed with all the variables considered as risk factors; one-way analysis of variance and binary logistic regression were used. Results: The most frequent cardiac complications were atrial fibrillation and heart failure (approximately 12 %). A metabolic control analysis on admission yielded altered results (OR = 6.92; LI: 2.61; LS: 18.32; p = 0.001). The univariate analysis showed that ten factors increased the risk of complications, including the diagnosis of diabetes mellitus ≥ 10 years (OR = 2.50; LI: 1.14; LS: 5.45; p = 0.020). On the other hand, the multivariate analysis revealed six factors that predict the development of cardiac complications: age ≥ 60 years (OR = 5.624; CI = 1.607-19.686; p = 0.007), altered metabolic control on admission (OR = 5.245; CI = 1.491-18.447; p = 0.010), lack of use of thrombolytic therapy (OR = 5.74; CI = 1.46-22.586; p = 0.012), left ventricular ejection fraction (LVEF) ≤ 40 % (OR = 5.245; CI = 1.17-23.433; p = 0.030), left atrial pressure ≥ 15 mmHg (OR = 12.335; CI = 3.45-44.08; p = 0.001) and motility ≥ 1.5 points (OR = 4.702; CI = 1.258-17.575; p = 0.021). Conclusions: The study demonstrated the value of six risk factors of cardiac complications among patients with diabetes and AMI, where glycemic control on admission, decreased LVEF, increased left atrial pressure and no reperfusion therapy stand out. [ABSTRACT FROM AUTHOR]

Introducción. El consumo de café ha sido vinculado con desenlaces negativos en salud pero, en la actualidad, existe evidencia sobre efectos preventivos de desenlaces cardiovasculares en pacientes con diabetes mellitus tipo 2. Objetivo. Realizar búsqueda, comparación y resumen de la evidencia sobre el efecto del consumo habitual de café en la prevención de desenlaces cardiovasculares en pacientes con diabetes tipo 2. Métodos. Revisión de la literatura de artículos obtenidos en bases de datos: Google Scholar, PubMed, Scopus y Science Direct, publicados en inglés o español, complementada manualmente con referencias de los artículos citados. Resultados. Se realizó una revisión de la literatura de 12 artículos científicos, que incluyeron metaanálisis, estudios de cohorte y observacionales transversales centrados en los efectos benéficos del consumo de café en la población diabética. El consumo de café inhibe la enzima glucosa-6-fosfatasa reguladora de los niveles de glucosa y reduce la rigidez arterial, lo cual se asocia a menor riesgo de enfermedad cerebrovascular y mortalidad cardiovascular. Conclusión. El café contiene propiedades vasodilatadoras, antiinflamatorias y antioxidantes, las cuales pueden estar relacionadas con sus beneficios cardiovasculares en pacientes con diabetes tipo 2. A partir de esta revisión

Background: The debate on percutaneous coronary intervention (PCI) of the unprotected left main coronary artery (LMCA) has been constant over time. Objective: To investigate the clinical and procedural characteristics and cardiovascular outcomes of PCI of unprotected LMCA. Material and methods: Observational study which included patients with unprotected LMCA disease undergoing PCI; patients with cardiogenic shock prior to the procedure were excluded. We describe the clinical and angiographic characteristics, as well as the major adverse cardiac and cerebrovascular events (MACCE) according to the year of the procedure. Results: We included 73 patients, with a SYNTAX I score of 31.2 ± 9.1, mostly with ST-elevation acute coronary syndrome (35%). There was a higher frequency of triple vessel coronary disease (63%) and distal LMCA lesions (35%). The provisional stent technique was the most used for distal lesions (58%) and the 2-stent technique for bifurcation lesions (78%), supported by intravascular ultrasound (IVUS) in 38%. During follow-up, 19 presented MACCE (26%), out of which cardiac death occurred in 13%, non-cardiovascular death in 5%, non-fatal acute myocardial infarction in 1%, cerebrovascular event in 2%, and revascularization of the treated vessel in 4%. Conclusions: It was observed a similar frequency to the one appearing in other studies of cardiovascular events, mainly in patients with intermediate risk, which supports the increasing use of percutaneous intervention in this population. [ABSTRACT FROM AUTHOR]

Copyright of Revista Salud Bosque is the property of Universidad El Bosque and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Enfermería Investiga: Investigaciin, Vinculación, Docencia y Gestiin is the property of Revista Enfermeria Investiga and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The right ventricle is susceptible to changes in preload, afterload, and contractility. The answer is its dilation with dysfunction/ acute failure; filling is limited to the left ventricle and cardiac output. Systemic venous congestion is retrograde to the right heart, it is involved in the genesis of cardiogenic shock due to right ventricle involvement. This form of shock is less well known than that which occurs due to left ventricular failure, therefore, treatment may differ. Once the primary treatment has been carried out, since no response is obtained, supportive treatment aimed at ventricular pathophysiology will be the next option. It is suggested to evaluate the preload for the reasoned indication of liquids, diuretics or even ultrafiltration. Restore or maintain heart rate and sinus rhythm, treat symptomatic bradycardia, arrhythmias that make patients unstable, use of temporary pacing or cardioversion procedures. Improving contractility and vasomotility, using vasopressors and inotropes, alone or in combination, the objective will be to improve right coronary perfusion pressure. Balance the effect of drugs and maneuvers on preload and/or afterload, such as mechanical ventilation, atrial septostomy and pulmonary vasodilators. And the increasing utility of mechanical support of the circulation that has become a useful tool to preserve/restore right heart function. [ABSTRACT FROM AUTHOR]

Copyright of Gaceta Médica de Caracas is the property of Academia Nacional de Medicina and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Argentina de Cardiología is the property of Sociedad Argentina de Cardiologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Acute Myocardial Infarction (AMI) is a preventable pathology with modifiable factors, making it of interest in public health. Objective: To identifies the factors associated with AMI in patients with arterial hypertension. Material and Methods: This study employed a cross-sectional design with correlational phase, analyzing 130 medical records from the Friends of the Heart program at Hospital San Rafael of Tunja, Boyacá, Colombia, for the year 2016. The sample was selected using the simple random sampling technique. Results: Non-modifiable factors revealed a mean age of 70 years and a weight of 65 kg. Of the participants, 54.6% were male, and 40.8% belonged to the lower-middle class. Concerning modifiable factors, 30.8% reported alcohol consumption, 60% were smokers, and 94.6% were sedentary. 84.6% had high-normal blood pressure, 44.6% reported overweight, 53.1% consumed drugs, with 29.2% receiving insulin and 33.1% antidepressants, 46.2% presented moderate cardiovascular risk. Additionally, 92.3% had normal cholesterol levels, 32.3% were diagnosed with type II diabetes, and 43.8% had AMI. Evidence suggests an association between AMI and the insulin administration (p=0.003), antidepressants (p=0.021), and the comorbidity of Type II Diabetes (p=0.001). Conclusions: Modifiable risk factors associated with AMI were identified, with insulin administration standing out as a protective factor. [ABSTRACT FROM AUTHOR]

Contexto: Dwight Eisenhower fue un veterano de guerra que se desempeñó como trigésimo cuarto presidente de los Estados Unidos de América durante dos mandatos. En su carrera política fueron comunes los impedimentos de salud, incluyendo fluctuaciones paroxísticas en la presión arterial, infartos agudos de miocardio múltiples y eventos cerebrovasculares. Una vez que falleció el expresidente en 1969, su autopsia reveló un feocromocitoma en la glándula adrenal derecha. Contenidos: los feocromocitomas son tumores secretores de catecolaminas que se desarrollan en las glándulas suprarrenales. Los síntomas se deben usualmente a una estimulación excesiva del sistema nervioso simpático, lo que genera hipertensión, cefalea, palpitaciones, diaforesis, palidez, entre otros. En su vida, Eisenhower sufrió varios eventos de salud que lo colocaron en una situación política tensa, donde tres de ellos fueron: su primer infarto agudo de miocardio, la cirugía por ileítis y el evento cerebrovascular isquémico. Al feocromocitoma se le atribuye la mayor responsabilidad acerca de sus problemas de salud, esto sumado a los malos hábitos de vida que poseía el expresidente. Conclusiones: en la época de los cincuenta y sesenta del siglo XX, el abordaje médico en general se realizaba de una manera totalmente distinta. Analizarlo en retrospectiva permite entender los cambios bioéticos y científicos que han impactado en la medicina durante los últimos 50 años y compararlos con los paradigmas que se tienen en la actualidad.

Introducción: La medida terapéutica más importante en pacientes con infarto agudo de miocardio con supradesnivel del segmento ST es la reperfusión del territorio isquémico; la fibrinólisis es la estrategia primaria en muchos hospitales. El diagnóstico temprano de aquellos pacientes con riesgo de fallo de trombólisis es vital.Objetivo: Identificar los factores pronósticos de fallo de trombólisis en pacientes con diagnóstico de infarto agudo de miocardio con supradesnivel del segmento ST.Métodos: Estudio descriptivo y prospectivo que incluyó a pacientes atendidos en la Emergencia del Hospital Clínico-Quirúrgico «Joaquín Albarrán», con diagnóstico de la enfermedad antes mencionada, y tratados con estreptoquinasa recombinante, entre noviembre de 2018 hasta mayo de 2020. Fueron incluidos 66 pacientes en la investigación. Las variables analizadas fueron: edad, sexo, hipertensión arterial, diabetes mellitus, tiempo entre inicio de síntomas y comienzo de fibrinólisis, localización del infarto, duración del complejo QRS, duración y profundidad de onda.Resultados: Hubo fallo de trombólisis en 27 pacientes (40,9 %). Las variables: Tiempo de realización de trombólisis, duración y profundidad de la onda Q, así como la duración del QRS mostraron valores con diferencias significativas entre ambos grupos (pConclusiones: El análisis de la profundidad y duración de la onda Q en el electrocardiograma inicial de los pacientes estudiados, permite predecir a una subpoblación de pacientes con riesgo de fallo de trombólisis.

Introducción: el infarto agudo de miocardio es una de las primeras causas de muerte a nivel mundial. En Cuba, las enfermedades cardíacas poseen una alta incidencia, posicionándose como la primera causa de muerte para ambos sexos. Objetivo: caracterizar los factores de riesgo del infarto agudo del miocardio en pacientes adultos pertenecientes al Consultorio del Médico de la Familia Número 18, Policlínico Máximo Gómez, municipio Holguín, en el periodo de enero de 2021 a diciembre de 2021. Métodos: se realizó un estudio observacional, descriptivo, de corte transversal. El universo estuvo constituido por 942 pacientes que cumplían con los criterios de inclusión; se seleccionó como muestra 450 pacientes mediante un muestreo aleatorio simple. Se analizaron las variables edad, sexo, factores de riesgo y cantidad de factores de riesgo, las cuales fueron obtenidas a través de las historias clínicas familiares e individuales y una encuesta. Se utilizó la estadística descriptiva. Resultados: predominaron los pacientes en el rango de edades de 50 a 59 años (20,89 %) y del sexo masculino (55,11 %). El 28,22 % y el 20,22 % del total de pacientes presentaron hipertensión arterial y hábito de fumar respectivamente, siendo los factores de riesgo más importantes. Existió predominio de pacientes con al menos un factor de riesgo (29,33 %). Conclusiones: existió predominio de los pacientes adultos masculinos con hipertensión arterial y hábito de fumar. La mayoría de los pacientes tenía al menos un factor de riesgo.

Background: acute myocardial infarction is one of the life-threatening conditions and the most important parameter to measure in the occurrence of adverse cardiovascular events. Objective: to characterize patients with a diagnosis of acute myocardial infarction of lower topography, attended at the Center for Cardiovascular Surgery and Cardiology, in the Provincial Hospital Clínico Quirúrgica Docente "Saturnino Lora Torres" from January, 2018 to November, 2022. Methods: a descriptive, longitudinal and retrospective investigation was carried out in the center and time period declared in the objective. The universe consisted of 330 patients with this diagnosis, choosing by simple random sampling, a sample of 177 patients. Clinical-epidemiological, echocardiographic and therapeutic variables were evaluated. The information was collected from data on individual medical records and echocardiographic reports. Results: patients aged 65 or older predominated (70.6 %), with a discrete greater presence of males (55.4 %). 137 (77.4 %) patients had complications (p = 0.0001), the most frequent was paroxysmal atrial fibrillation (16 %), followed by right ventricular infarction (10 %). Most patients received thrombolytic therapy (69.5 %). There was an association between altered values of: left ventricular systolic function, right ventricular tissue doppler, left atrial pressure, left atrial volume and the presence of complications. Conclusions: patients with acute myocardial infarction of lower topography included in the study were characterized.

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Copyright of Revista Argentina de Cardiología is the property of Sociedad Argentina de Cardiologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Dyslipidemia is a risk factor for the development of atherosclerosis and ischemic heart disease. Statins are safe drugs that are part of the routine treatment in patients with Acute Myocardial Infarction (AMI), however, rhabdomyolysis associated with severe myonecrosis due to statins can occur and associated complications such as acute kidney injury increase mortality. The main objective of this article is to report the case of a critically ill patient with AMI who presented severe statin-associated rhabdomyolysis documented with muscle biopsy. Description of the case: A 54-year-old man who presented with AMI, cardiogenic shock, and cardiorespiratory arrest requiring cardiopulmonary resuscitation, fibrinolysis, and successful salvage coronary angiography. However, he presented severe rhabdomyolysis associated with atorvastatin that required suspension of the drug and multi-organ support in a Coronary Care Unit. Conclusions: The prevalence of statin-associated rhabdomyolysis is low, however, the late elevation of CPK above 10 times its upper normal value in those patients with successful percutaneous coronary angiography should promptly draw attention, generate a diagnostic approach towards non-traumatic acquired causes of rhabdomyolysis and assess the suspension of statins. [ABSTRACT FROM AUTHOR]

El ejercicio de la Enfermería tiene un alto componente de responsabilidad y comportamiento ético para el control emocional de las personas con antecedentes de infarto agudo de miocardio. Este sustento le da significado a la práctica de la Enfermería para ser aplicada de forma sistemática y organizada. Se realizó una investigación descriptiva con el objetivo de proponer acciones, desde la Enfermería, que contribuyan al mejoramiento del control emocional en las personas con antecedentes de infarto agudo de miocardio pertenecientes al Policlínico Docente Universitario «Martha Abreu de Estévez», de Santa Clara, Villa Clara, en el período de enero de 2017 a febrero de 2019. En las personas estudiadas se constató un predominio de: autoestima baja, alta vulnerabilidad al estrés y la ansiedad. Por otro lado, se evidenciaron dificultades en el conocimiento de sus estados emocionales, incapacidad para clarificar y reparar sus emociones, así como una satisfacción vital no satisfactoria.

Introducción: Los aneurismas ventriculares se definen como un segmento discinético o acinético de un área dilatada que ocasiona disminución de la función ventricular. Es comúnmente causado por el infarto de miocardio en presencia de las manifestaciones típicas de la enfermedad. El objetivo es describir la presentación atípica de un paciente con lesión aneurismática apical del ventrículo izquierdo por infarto agudo de miocardio (IAM) silente que desarrolló embolia obstructiva de la arteria femoral. Consultó por cuadro clínico de 3 días de evolución consistente en dolor en extremidad inferior derecha de inicio súbito e intensidad moderada-severa, asociado a cianosis y sensación de parestesias en la extremidad. Caso clínico: Presentamos el caso de un paciente que consultó por dolor en la extremidad inferior derecha, de inicio súbito e intensidad moderada-severa, asociado a cianosis y sensación de parestesias, por lo que realizaron una ecografía Doppler que evidenció trombo a nivel de arteria femoral derecha, que se extendía a la arteria poplítea, secundario a un mecanismo cardioembólico causado por un aneurisma apical del ventrículo izquierdo tras un infarto agudo de miocardio silente, que fue tratado exitosamente en dos centros asistenciales mediante anticoagulación, embolectomía femoral derecha, angiorrafia femoral y colocación de stent en coronaria derecha y en la descendente anterior. Conclusiones: Resaltamos la importancia de considerar los diagnósticos diferenciales pocos frecuentes en la práctica clínica y de curso asintomático, la asociación entre la localización de LVA y el desarrollo de manifestaciones clínicas y complicaciones como el tromboembolismo en la LVA asociado a IAM transmural silente.

Copyright of Revista Argentina de Cardiología is the property of Sociedad Argentina de Cardiologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: to identify the incidence, risk factors and outcomes associated with myocardial infarction with nonobstructive coronary arteries (MINOCA). Method: it is a with prospective cohort study data collection from medical records data. Patients with acute myocardial infarction (AMI) that went through hemodynamic study in 2017 and 2018 were included. Results: when analyzing 445 medical records, the occurrence of MINOCA was observed in 28 patients (6.3%). Comparing the MINOCA group with the obstructive AMI group, patients in the MINOCA group were younger, with a mean age of 54 years (SD ± 14; p=0.007), had a lower incidence of smoking (2 versus 156, p<0.001), hypertension (10 versus 242; p=0.002), shorter mean length of hospital stay (days) (5.79 ± 3.05 versus 7.49 ± 5.20; p= 0.02) and fewer admissions to intensive care unit (5 versus 212; p=0.002). Conclusion: the estimated incidence of MINOCA among the total number of AMI in southern Santa Catarina was 6.3% [CI 95]. Patients in the MINOCA group had a lower prevalence of comorbidities, better in-hospital evolution and better outcome. [ABSTRACT FROM AUTHOR]

Copyright of INSPILIP. Revista Ecuatoriana de Ciencia, Tecnología e Innovacion en Salud Pública is the property of Instituto Nacional de Investigacion en Salud Publica (INSPI) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Acta Medica Colombiana is the property of Acta Medica Colombiana and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: morbidity and mortality related to cardiovascular diseases, and acute myocardial infarction in particular are a health problem. Objective: to determine the relationship between complications, clinical and echocardiographic variables in patients with acute myocardial infarction, assisted at Cardiovascular Surgery and Cardiology Center on "Saturnino Lora Torres" Hospital, in Santiago de Cuba from 2017 to 2021. Methods: an ambispective, analytical, case-control study of 255 patients assisted in the center and period of time previously defined. Divided into two groups, one of the cases who presented complications (85 patients) and the other for the control group (170), for a 1:2 ratio. Results: average age was 60 years in the cases and 57 years in the controls, >65 years behaved as a risk factor for complications. The most frequent complications were: myocardial infarction with extension to the right ventricle (24 %), cardiogenic shock (16 %), acute heart failure and paroxysmal atrial fibrillation (15 % of both). The use of thrombolytic therapy was a protective factor. Left ventricular ejection fraction (LVEF), right ventricular systolic function (TDI RV) and mean pulmonary artery pressure showed statistically significant association with complications. No left atrial pressure was associated. Conclusions: age, left ventricular ejection fraction, mean pulmonary artery pressure and TDI RV were predictors of complications in acute myocardial infarction. Thrombolytic therapy is a protective factor.

Since 2015, the Instituto Mexicano del Seguro Social (IMSS) has developed and implemented the Infarction Code emergency care protocol, with the aim of improving the diagnosis and treatment of acute myocardial infarction and thus eventually reducing mortality. In the context of the federalization and implementation of the new IMSSBienestar care model in several states, the possibility of increasing the coverage and extension of the protocol service networks is presented, not only to eligible population but also to those who do not have social security and resides in contexts of social marginalization, to comply with article 4o. constitutional. This document describes how the proposal was made to extend and increase the service network of the Infarction Code care protocol, based on material, human and infrastructure resources of the IMSS ordinary regime and IMSS-Bienestar. [ABSTRACT FROM AUTHOR]

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Copyright of Journal of Nursing & Health is the property of Journal of Nursing & Health (JONAH) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objetivo. Evaluar la repercusión de la pandemia del COVID-19 sobre el abordaje del infarto de miocardio con elevación del segmento ST (IMCEST) en un centro de referencia en el norte del Perú. Métodos. Se realizó un estudio observacional, analítico, tipo cohortes retrospectivas, derivado del registro de síndrome coronario agudo del Hospital Nacional Almanzor Aguinaga Asenjo. Se compararon las características de los pacientes con IMCEST y sus desenlaces a 30 días en dos cohortes según el momento de atención médica: previo a la pandemia o durante pandemia. Resultados. Durante la pandemia del COVID-19 disminuyeron las hospitalizaciones por IMCEST en 53%; hubo mayor empleo de fibrinólisis en detrimento de la angioplastia primaria, con incrementos en el tiempo de primer contacto médico (100 vs. 240 min, p= 0,006) y tiempo de isquemia hasta el intervencionismo coronario percutáneo (900 vs. 2880 min, p < 0,001). Se encontró mayor frecuencia de falla cardiaca posinfarto (21,1% vs. 46,7%, p= 0,002) y menor fracción de eyección del ventrículo izquierdo al alta (49,2 +/- 8,6 vs. 44,8 +/- 9,3, p= 0,009), sin que esto se refleje en un incremento de la mortalidad cardiovascular intrahospitalaria. Conclusiones. La pandemia COVID-19 ha tenido un impacto negativo en el abordaje de pacientes con IMCEST, disminuyó las hospitalizaciones y prolongó los tiempos de reperfusión generando mayor frecuencia de falla cardiaca posinfarto y menor fracción de eyección del ventrículo izquierdo al alta.

Introducción: las enfermedades del corazón constituyen la principal causa de mortalidad en Cuba, donde las cardiopatías isquémicas y el infarto agudo del miocardio, presentan elevada incidencia. Objetivo: caracterizar las tendencias en la producción científica cubana sobre infarto agudo del miocardio en Scopus en el periodo 2011–2021. Método: estudio observacional, descriptivo, bibliométrico de la producción científica cubana sobre infarto agudo del miocardio en Scopus entre 2011 y 2021. Se estudiaron el número de documentos, tipología, año de publicación, tasa de variación de la producción, revista, número de citas, indicadores de la familia del índice h, número de autores, organización que financió el estudio y colaboración de autores foráneos. Se emplearon los programas VOSviewer 1.6.11, y Harzing’s Publish or Perish. Resultados: de los 52 artículos, el 84,6 % fueron originales. Los artículos fueron publicados en 25 revistas; de ellas, 7 nacionales, donde las más productivas fueron Revista Cubana de Cardiología y Cirugía Cardiovascular, con 7 artículos, y Medicc Review, con 6. Se recibieron un total de 86 citas, con una media de 8,6 citas al año y 1,65 citas por artículo y un índice h de 5. Se identificó colaboración con investigadores de ocho países, donde Estados Unidos reportó el mayor número de colaboraciones (3). Conclusiones: la producción científica cubana en Scopus sobre infarto agudo del miocardio se caracterizó por ser baja, con un predominio de artículos originales y una tendencia al estancamiento o decremento cuantitativo. Se evidenció un creciente impacto científico, así como la colaboración entre investigadores cubanos y foráneos.

Contexto: Factores dietarios poco saludables se han asociado con aumento de riesgo cardiovascular, uno de ellos; consumo de azúcar. Objetivo: Búsqueda, evaluación y análisis de la mejor evidencia disponible sobre el consumo de azúcar y desenlaces mayores cardiovasculares. Metodología: Revisión sistemática de la literatura. Evaluación cuantitativa entre consumo de azúcar y alguno de los siguientes eventos cardiovasculares mayores (muerte cardiovascular, infarto agudo de miocardio no fatal o accidente cerebrovascular no fatal). Se incluyeron participantes mayores de 18 años no gestantes, sin cardiopatía congénita. Resultados: Se incluyeron 31 estudios primarios (27 estudios de cohortes y 4 estudios de casos y controles). Veintiuno evaluaron el consumo de azúcar e infarto agudo de miocardio, 12 consumo de azúcar y accidente cerebrovascular y 6 consumo de azúcar y muerte cardiovascular. Para los 3 desenlaces los resultados fueron controversiales, sin embargo, con significancia estadística en varios estudios para la asociación en cuestión, al evaluarse el consumo de azúcar por carga glucémica, índice glucémico, carbohidratos totales, entre otros. Conclusiones: Sin bien la evidencia es contradictoria, sugiere de forma consistente a partir de estudios de cohorte que los carbohidratos con alto índice glucémico, azucares añadidos y bebidas azucaradas, aumentan el riesgo de presentar eventos adversos cardiovasculares mayores como infarto agudo de miocardio, ataque cerebrovascular y muerte cardiovascular.

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Background: diabetic patients with acute myocardial infarction have more complications and higher mortality. Objective: to describe clinical and epidemiological aspects in diabetic patients with acute myocardial infarction and their possible relationship with glycemia values on admission. Methods: a descriptive, retrospective study was carried out with 332 diabetic patients with acute myocardial infarction according to blood glucose levels on admission. The blood glucose cutoff point was 7,1 mmol/L. Qualitative variables were reported as percentages and quantitative variables as mean and standard deviation. To assess the relationship between variables of interest (qualitative), Pearson's chi-square test was applied. Comparison average age according to sex was performed using Student's t-test. The level of significance α = 0,05 was used in all hypothesis tests. Results: the average age was 67,8 ± 10,5 years. 31,9 % were between 71 and 80 years old and 77,4 % were hypertensive. In patients with glycemia on admission ≥7,1 mmol/L, anterior topography predominated (22,5 %). KK IV (p = 0,004) and atrioventricular block (p = 0,031) were significantly associated with these glycemia values. 40,3 % presented some degree of heart failure during admission. Conclusions: diabetic patients with acute myocardial infarction were described, who had a significant association between complications and glycemia values on admission ≥7,1 mmol/L.

Background: the prevalence of metabolic syndrome is higher in the presence of acute myocardial infarction than in the general population and its characteristics are not well known in our territory. Objective: to describe the components of the metabolic syndrome in patients with acute myocardial infarction treated at the “Dr. Ernesto Guevara de la Serna” General Teaching Hospital of Las Tunas, from September 2017 through August 2019. Methods: a descriptive, cross-sectional study was carried out at the cardiology department of the aforementioned hospital and during the period herein stated. A sample of 215 patients with acute myocardial infarction was studied to whom the analyses could be performed in the first 24 hours. Patients with associated infectious, immunological, hematological and oncological diseases were excluded. Descriptive statistics was used for data analysis. Results: 40,9 % of the patients with infarcted myocardium had metabolic syndrome. 56,8 % were male. The average age was 65 ± 11 years, the majority age group was that over 65 years. 69,3 % had predominance of three components of the syndrome, the most frequent ones were: high blood pressure (96,6 %), high blood glucose (70,5 %) and abdominal obesity (68,2 %), being the most common association. The prevailing inflammatory markers were neutrophilia and ultrasensitive C-reactive protein. Conclusions: the components of the metabolic syndrome were described in patients with acute myocardial infarction included in the study.

Background: the epidemiological characteristics of acute myocardial infarction have changed in the last decades. Objective: to characterize the patients with acute myocardial infarction admitted to the “Dr. Ernesto Guevara de la Serna” General Teaching Hospital of Las Tunas, from June 2018 through June 2020. Methods: an observational, descriptive and cross-sectional study was carried out at the department of cardiology of the aforementioned hospital and during the period herein stated. The study universe was made up of 754 patients who were admitted with acute coronary syndrome and the study sample consisted of 440 patients with a confirmed diagnosis of acute myocardial infarction. For the data treatment percentage analysis was used for the qualitative variables and arithmetic mean with standard deviation for the quantitative ones. Results: the average age of the patients was 65.9 ± 12.3 years. 64.1% were male and 76.8 % suffered from arterial hypertension. 81.8 % did not have heart failure at admission. 78.4 % presented ST-elevation infarction, thrombolysis was performed on 45.2% and out of them 83.4 % achieved total reperfusion. 31.4% developed left ventricular dysfunction. Hospital mortality was 8.8 %. In more than 90% aspirin, clopidogrel and statins were prescribed at discharge. 20.2% was referred to cardiac rehabilitation. Conclusions: most of the patients were male, with ST-segment elevation myocardial infarction and with a low percentage of reperfusion. Arterial hypertension was the most frequent associated factor. Hospital mortality was low.

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Copyright of Universidad Médica Pinareña is the property of Editorial Ciencias Medicas and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Sexuality has been present throughout the life of the human being including aspects such as sexual activity, identity, roles, orientation, eroticism, etc. People who have suffered an Acute Myocardial Infarction (AMI) sexuality is affected by psychological, physical and even social factors. Therefore, the main purpose of this research is to describe the meaning of sexuality from someone has suffered AMI from a phenomenological perspective. Method: Qualitative study with a phenomenological approach, which sample consisted of 19 people who suffered acute infarction of the myocardium and who were treated by the emergency department or internal medicine of an institution of fourth level of complexity in the city of Bucaramanga (Colombia). Indepth interviews were applied and coded using the Atlas.ti 6.1 version. The analysis was carried out using the Colaizzi model. Results: The sexuality of the person who has suffered an acute infarction of the myocardium is associated with multiple situations that are not only related to the sexual act. It is also linked with the emotional relationships such as, sharing with their partner, family, and friends. It shall be understood that this experience triggers negative and positive aspects that could affect the sexual expression or enhance it. Conclusions: The meaning of sexuality for a person who has suffered acute infarction of the myocardium is given by emotions, care, education, beliefs and changes in sexuality, which impact patient's process of recovery from their disease and their quality of life. [ABSTRACT FROM AUTHOR]

Lipoprotein(a) (Lp (a)) is a plasmatic lipid protein complex, which represents a risk factor for atherosclerotic cardiovascular disease (ASCVD). However, conventional lipid assays are unable to measure or estimate Lp (a) and there are no specific therapies approved to substantially reduce Lp (a) concentrations. We report the case of a 49-year-old man with low cardiovascular risk who developed an acute myocardial infarction with ST elevation probably due to elevation of Lp (a) is reported. The purpose of this case report is to highlight the detection and analysis of Lp (a) in the assessment of cardiovascular risk. In addition, current and emerging therapies are described in patients with elevated Lp (a). [ABSTRACT FROM AUTHOR]

Copyright of Revista Argentina de Cardiología is the property of Sociedad Argentina de Cardiologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: The myocardial infarction-associated (MI) mortality is not only due cardiovascular complications, but intrahospital non-cardiovascular complications (IHnCVCs). The leuko-glycemic index (LGI) has been used as a prognostic marker for the development of cardiovascular complications in MI. We focused this study on identifying the cut-off point of LGI for the IHnCVCs development in patients with ST-segment elevation myocardial infarction (STEMI). Material and methods: In this single-center and crosssectional design, we included patients with STEMI. The biochemical analysis included glucose and leucocytes; with them we calculated the LGI. Receiver operating characteristic curve, univariate and bivariate analysis, and multivariate analysis for IHnCVCs development were performed. A p < 0.05 was considered statistically significant. Results: We included 1294 patients, 79.8% were men and 20.2% women. The main comorbidities were hypertension, diabetes mellitus and dyslipidemia. Six hundred forty-four (49.8%) patients presented IHNCVCs. The LGI > 1200 (AUC 0.817) predict the IHNCVCs development in STEMI patients. The variables that increased the IHNCVCs development were LGI > 1200, creatinine > 0.91 mg/dL, diabetes mellitus and age > 65 years. Hospital acquired pneumonia and cardiovascular complications increase the risk of death among STEMI patients. Conclusion: A LGI > 1200 increased, just over nine times, the risk of IHnCVC development in STEMI patients. [ABSTRACT FROM AUTHOR]

To determine the epidemiological and clinical characteristics of patients with acute myocardial infarction, a descriptive study was conducted in 175 patients in a referral hospital in Lima. The average age of the patients was 68.7 ± 10.8 years and 74.8% were male. The main reperfusion strategy used was percutaneous transluminal coronary angioplasty + stent, however, the use of primary angioplasty was low (19.5% of patients with ST elevation myocardial infarction). Time to reperfusion therapies (angioplasty or fibrinolysis) were longer than recommended and the percentage of surgical revascularization was high. Almost 60% of the patients had a length of stay longer than seven days. In-hospital mortality was 3.4%, with cardiogenic shock being the most frequent cause of death. Myocardial infarction mainly affects men over 60 years, the clinical and epidemiological variables are like other regional reports. The main reperfusion strategy is angioplasty, although the use of primary angioplasty is low. Time to performing reperfusion is longer than recommended and the percentage of surgical revascularization is high.

Introduction: acute myocardial infarction is a disease with high morbidity and mortality. Objective: to determine the knowledge level of medical students about the diagnosis and management of acute myocardial infarction. Method: an observational, descriptive and cross-sectional study was carried out between January and February 2022 in medical students from the University of Medical Sciences of Pinar del Río who participated in the provincial update workshop on acute myocardial infarction. Through intentional sampling, a sample of 92 students was selected. To collect the information, a survey was used using Google Forms. Results: the female sex (65,21%), the age group from 21 to 22 years (65,21%) and the fourth-year students (50%) prevailed. Hypertension was the most identified risk factor (97,98%). 97,82% of the students identified precordial pain as the main clinical manifestation. 100% identified the presentation with complications, where sudden death was the most identified (81,52%). 100% point to the electrocardiogram as the main complementary, where ST alterations were the most identified (84,78%). 95,65% of the students indicated constant monitoring of vital parameters and cardiovascular function as the management measure. Conclusions: Medicine students belonging to the clinical area at the University of Medical Sciences of Pinar del Río have an adequate level of knowledge about the diagnosis and management of acute myocardial infarction.

Introducción: el síndrome de Kounis se ha establecido como un trastorno coronario asociado a reacciones alérgicas, de hipersensibilidad, anafilácticas y anafilactoides; que engloba conceptos como el de angina alérgica e infarto alérgico. Su incidencia ha sido difícil de establecer debido a que posee una gran cantidad de factores desencadenantes y que existen pocos registros en la literatura médica, de modo que no parece ser un síndrome raro sino una entidad clínica poco conocida, capaz de evolucionar fatalmente si no se reconoce y se trata de manera rápida. Objetivo: Resaltar y consolidar la literatura reciente sobre el síndrome de Kounis y así actualizar los conocimientos del médico en dicho tópico. Métodos: se realizó una revisión narrativa de la literatura encontrada en las bases de datos PubMed y Science Direct y en el motor de búsqueda Google Scholar utilizando las palabras claves. Se incluyeron artículos en idioma español e inglés publicados hasta el mes de agosto de 2021. Resultados: las reacciones alérgicas graves pueden desencadenar eventos coronarios agudos, esto se conoce como síndrome de Kounis. Se han descrito múltiples causas y sus manifestaciones clínicas pueden variar. La participación de los mastocitos cardíacos es fundamental en su desarrollo, a través de la liberación de múltiples mediadores que pueden desencadenar eventos agudos como vasoconstricción coronaria, rotura de placa ateroesclerótica y trombosis del stent coronario. Su diagnóstico se basa en las características clínicas, así como en pruebas de laboratorio, electrocardiográficas, ecocardiográficas y angiográficas. A pesar de que no existen guías de tratamiento para los pacientes con esta entidad, la literatura parece estar de acuerdo en que el manejo de dicha entidad en su fase aguda, debe involucrar el tratamiento del síndrome coronario agudo y la supresión de la reacción alérgica, teniendo en cuenta las interacciones y efectos de los fármacos a emplear. Conclusión: El síndrome de Kounis es un trastorno común y potencialmente mortal que se debe diagnosticar y tratar de forma idónea e inmediata; por tanto, el conocimiento de su epidemiología, etiología, patogenia y manifestaciones clínicas son importantes para su diagnóstico, y tratamiento. El clínico debe prestar especial atención ante cualquier reacción alérgica que preceda al evento cardíaco agudo y considerar el SK en el gabinete de diagnósticos diferenciales.