Pericardial cysts are an infrequent entity. In the literature reference is made to a prevalence of 1/100000 over the general population. They are usually of congenital origin and only rarely are they acquired. Despite the fact that the most frequent clinical presentation is asymptomatic and the prognosis is benign, important complications have been described. The case we detail is interesting because the main symptom was syncope and it was associated with an obstruction of the right ventricle outflow tract. The diagnosis was made through imaging tests such as transthoracic echocardiography, transesophageal echocardiography, and magnetic resonance imaging. The orderly and adequate use of the imaging studies allowed to make the most appropriate decision for the patient. We opted for surgical treatment due to the location of the pericardial cyst and to avoid complications such as rupture.Key words: syncope, pericardial cyst resumen Los quistes pericárdicos son una entidad infrecuente. En la literatura se hace referencia a una prevalencia de 1/100000 sobre la población general. Suelen ser de origen congénito y solo en raras ocasiones son adquiridos. A pesar de que la forma de presentación clínica más frecuente es asintomática y el pronóstico es benigno, se han descrito importantes complicaciones. El caso que detallamos es interesante debido a que el síntoma principal fue el síncope y estuvo asociado a una obstrucción del tracto de salida del ventrículo derecho. El diagnóstico se realizó mediante las pruebas de imágenes como ecocardiografia transtorácica, ecocardiografía transesofágica, resonancia magnética. El uso ordenado y adecuado de los estudios de imágenes permitió tomar la decision más adecuada para el paciente. Optamos por el tratamiento quirúrgico debido a la localización del quiste pericárdico y para evitar complicaciones como su ruptura.
We report the case of a patient 20-year-old woman with Dyspnea and chest pain associated with moderate effort, with no heart disease previously known. The assessments showed dilatation of main trunk and branches of pulmonary artery with severe pulmonary regurgitation, mild pulmonary hypertension, mild dilation and moderate right ventricle hypertrophy; that underwent surgery for severe pulmonary insufficiency and to surgically cure pulmonary aneurysm. The intraoperative review found an Agenesis of the septal leaflet of the pulmonary valve and pulmonary artery aneurysm. A change of pulmonary valve and plasty aneurysm was performed.Key words: pulmonary artery aneurysm, pulmonary valve agenesis, echocardiography resumen Reportamos el caso de una paciente mujer de 20 años con disnea y dolor torácico asociado a esfuerzo moderado, sin enfermedad cardiaca conocida, previamente. Las evaluaciones demostraron dilatación de tronco principal y ramas de arteria pulmonar con regurgitación pulmonar severa, hipertensión pulmonar leve, dilatación leve e hipertrofia moderada de ventrículo derecho; sometida a cirugía por insuficiencia pulmonar severa y cura quirúrgica de aneurisma pulmonar. El hallazgo intraoperatorio fue agenesia del velo septal de la válvula pulmonar y aneurisma de arteria pulmonar y sus ramas. Se realizó un cambio de válvula y plastía del aneurisma.
Estimate the risk of coronary heart disease is possible with the use of tools such as the Framingham score. Systolic hypertension according to the guidelines of the current Clinical Practice Guidelines constitutes a valid starting point for the investigation of coronary disease associated with its prevalent risk factors such as diabetes Mellitus, dyslipidemia and smoking. The goal of this research was to determine the coronary risk in people with isolated systolic hypertension or associated with prevalent cardiovascular risk factors. Relevant data was collected from 1469 users in the Department of Cardiology National of the PNP Hospital "Luis N. Sáenz" during the 2012-2013 period, estimating the probability of coronary disease and identifying the high intermediate risk profile. From those 1469 users, 706 (48.06%) were male and 763 (51.94%) of female gender; 65.49% of them between 60 and 79 years. Diabetes Mellitus Type 2 was identified in 365 (24.85%) patients, obesity in 387 (26.34%) and dyslipidemia in 768 (52.28%). The coronary risk according to the Framingham score, resulted in low risk at 36.76%, moderate for 30.50% and high and very high at 32.74%. The high coronary risk is very high and most often presented between 70 and 79 years old. Arterial hypertension alone or associated with other cardiovascular risk factors increases coronary risk. Other factors associated with high risk are chronic kidney disease having a previous stroke. The Framingham score has proven useful in the calculation of coronary risk.
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