Objetivo: Presentar el caso clínico de un paciente con pseudoaneurisma fibroso intervalvular mitroaórtico (PFIMA) con insuficiencia mitral aguda, así como el tratamiento clínico, los métodos diagnósticos y el tratamiento definitivo empleado. Detalles del caso: Este es un estudio de caso aprobado por el Comité de Ética en Investigación (CEP) con la opinión 2.696.862. Una paciente de 18 años, tras presentar un cuadro clínico de insuficiencia cardiaca aguda, fue diagnosticada de PFIMA mediante estudio ecográfico con ecocardiografía transtorácica (ETT) y complementado con ecocardiografía transesofágica. Así, fue necesario cambiar la válvula mitral por una bioprótesis mitral que se produjo en la misma hospitalización sin complicaciones, siendo dado de alta al poco tiempo de la ETT de control. Consideraciones finales: Es una entidad clínica rara, de etiología derivada de cirugía cardíaca o endocarditis, en la mayoría de los casos, o se consideran congénitas por no tener una causa definida. Las complicaciones son la principal preocupación, ya que puede complicarse con diversas entidades y con ello, puede ocurrir la muerte del paciente, sobre todo si no se reconoce precozmente y se trata adecuadamente.
Diabetes Mellitus (DM) is a chronic cardio-metabolic disease and plays an important role on cardiovascular outcomes, most importantly when associated with an already established heart disease. Its effects in the body involve both metabolic and structural changes. To avoid such complications, in addition to the strategies already used and known, rises the Empaglifozin, a sodium glucose co-transporter inhibitor 2 (SGLT2). Its benefits and efficacy have been tried and tested in large-scale trials, with multidimensional cardiovascular effects that go beyond the adequate glycemic control. The EMPA-REG Outcome materialize such benefits, especially for people at high cardiovascular risk, when significantly reduced cardiovascular death and death from any cause in this population.
Heart failure (HF) is a crescent, solemn and multiple etiology worldwide health problem, which, besides potentially fatal, decreases the life quality of the affected people, mainly the elderly. Despite having obtained drugs that help in the disease development control, have been sought new alternatives for better management of these individuals. The LCZ696, a neprilysin inhibitor (sacubitril) associated with an ARB (valsartan) has shown significant improvements in patients' morbidity and mortality, which puts it as a good and interesting option for the treatment of heart failure.
Background: Heart failure (HF) is a chronic and incapacitant disease with bad prognosis, and it is commonly related to psychosocial comorbidities that difficult treatment adhesion. The prevalence of depression in HF varies from 20 to 40%, occurring 3 to 5 times more frequently in patients with HF than general population. The coexistence of depressive symptoms depreciates heart condition in patients with HF: depressive symptoms predict mortality, re-hospitalization, and an augment of symptoms in those patients. Aiming to clarify certain aspects of this comorbidity, it was performed a systematic review using Scopus and MEDLINE/PubMed databases, correlating HF and depression, from January 1, 2013, to August 20, 2017, by means of the descriptors found in MeSH: “heart failure” and "depression". Methods:Data screening applied combinations, as follows: #1. “Heart Failure” [MeSH Terms]; #2. “Depression” [MeSH Terms]; #3. “Management” [Keyword], using the following research strategy: (#1 AND #2) AND #3. Results:Improvement in depression levels through interventions using telephone is extensively reported in literature, based on providing information about the disease, self-care accompaniment, or cognitive behavioral therapy (CBT). Because of this, it is shown as an effective alternative in depression, improving surviving rates. Equally effective interventions were the empowering of the patient and the familial engagement in caring, palliative care and multidisciplinary participation in construction of caring program. Conclusions: Curiously, physical exercises did not show, statistically, efficiency in depression improvement, and few were the articles approaching antidepressant medications use in this class of patient.
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