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Biomedical subjects

J Delgado Jiménez

Publications and source records attributed to J Delgado Jiménez.

4 recordsLinked to original sources

[Cardiomyopathies (VII). Natural history of hypertrophic cardiomyopathy].

After a short historic review of conceptual developments in hypertrophic cardiomyopathy, the natural history of the disease is analyzed according to each of its morphologic and functional abnormalities. The lack of association between hypertrophic morphology and sudden death is considered. Diastolic dysfunction and LV obstruction, although a frequent cause of dyspnea and heart failure, is not a risk factor for sudden death. Something similar occurs with the infrequent appearance in this disease of contractile failure. Myocardial ischemia is frequent in hypertrophic cardiomyopathy and general prognostic information about it is still lacking. Nevertheless, in young patients with family history of sudden death, a positive Thallium effort test may be a marker of sudden death (without an arrhythmogenic substrate), and may respond to verapamil. Finally, the new knowledge about genetic mutations in hypertrophic cardiomyopathy are analized. We conclude with some futuristic comments about hypertrophic cardiomyopathy.

Adolescent↗

[Pulmonary hypertension: current aspects].

Primary pulmonary hypertension, although less frequent than secondary forms, represents the true paradigm of this disease. The recent investigations on pulmonary vascular response mechanisms to different stimuli has increased our knowledge about the mechanism of high pulmonary pressure. Molecular biology of the endothelial cell has provided evidence that endothelial injury plus a genetic individual predisposition may be the pathogenic mainstream of this disease. The histologic findings of pulmonary hypertension are still a matter of controversy, although the clinical, epidemiological and prognostic features are better defined. Therapeutically, there has been important advances, specially with various vasodilators, like calciumantagonists, prostacyclin, adenosine and nitric oxide, as well as new routes of administration. In more advance stages of the disease, atrial septostomy (only paliative) and pulmonary or cardio-pulmonary transplantation, are other therapeutic options to consider, after an adequate selection of patients.

Algorithms↗

[The importance of determining oxygen consumption in the indications for a heart transplant].

Maximal exercise performance in patients with chronic heart failure, as determined by peak oxygen consumption (VO2max.) during exercise testing has been shown to correlate well with mortality and its use as primary determining factor in the selection of patients for heart transplant has been advocated. Patients with a VO2max of less than 14 ml/kg/min appear at particularly high risk for mortality. Exercise performance can be influenced by a number of independent factors including subject motivation, peripheral deconditioning or other intrinsic abnormalities of skeletal muscle, and primary respiratory disease. It appears to be a precise gauge of functional impairment. VO2max can be used to accurately and reproducibly place an individual in a predefined functional class.

Anaerobiosis↗

Right coronary artery-right atrium fistula in primary angiosarcoma of the heart.

We report a case of angiosarcoma of the heart, manifested as a continuous murmur. Right coronary arteriography disclosed a paracardiac mass with fistulas from the coronary vessel to the right atrium. Histologic study revealed this to be an angiosarcoma with sinusoidal pattern. To our knowledge, this is the first case of this kind of cardiac tumor presenting as a fistula from a coronary artery to the right atrium.

Coronary Disease↗