Biomedical subjects

R Enciso

Publications and source records attributed to R Enciso.

28 records · Page 2Linked to original sources

PubMedDate not supplied

[Spontaneous aneurysm of the patent ductus arteriosus with endarteritis. A case report].

The spontaneous aneurysm of the ductus arteriosus is an extremely rare disease. From a total of 24 adult cases reported in the literature up to 1987, only in one case the ductus was open and other, was recanalized after being closed. We described the second case in the literature in a patient with totally permeable ductus arteriosus who developed a spontaneous aneurysm and endarteritis, showing the great importance of the diagnostic procedures such as echocardiogram, tomography and angiogram, as well as the surgical treatment which was successful in our patient. The probable etiology of this disease is discussed.

Adolescent↗

PubMedDate not supplied

[Circadian rhythm in myocardial infarct].

In order to determine if the beginning of the Myocardial Infarction (MI) is at random along the day or if it follows a circadian rhythm, we analyzed the clinical charts of 819 patients admitted to the Coronary Care Unite. Among them, 645 were male and 174 female. It was established that the beginning of the MI follows a circadian rhythm with maximal frequency between 8 and 9 a.m. and minimal at 0 hours (p greater than 0.01). This rhythm is sex independent. In patients younger than 45 years as well as those who received beta-block agents in less than 24 hours previous the MI no circadian rhythm was observed.

Adrenergic beta-Antagonists↗

PubMedDate not supplied

[Calculation of the mitral valve area with the proximal convergent flow method with Doppler-color in patients with mitral stenosis].

In this study we evaluate prospectively a new color Doppler method for calculating the mitral valve area based on identifying a blue-red aliasing interfase proximal to the orifice, corresponding to the flow convergence region (FCR). This method can be used to calculate areas using the continuity equation. We studied 61 patients with stenosis. The mitral valve area was calculated using pressure half-time (PHT) Doppler method which were compared with values that obtained by the FCR method, according to the following formula. AVM (cm2) = 2 pi r2 x VN/Vmax; where "r" is the FCR radius measured from the orifice to the first color aliasing (blue-red interface); VN is Nyquist velocity and Vmax is the peak flow velocity by continuous wave Doppler. Twenty three patients had pure mitral stenosis and 38 double mitral lesion. Twenty patients were on sinus rhythm while 41 in atrial fibrillation. Calculated mitral valve area using the FCR method correlated well with mitral valve area determined by PHT method at a correlation coefficient of r = 0.96 (y = 0.097 x + 54.9, SEE = 0.10 cm2, p < 0.001). MVA by FCR ranged from 0.4 to 2.5 cm2 (mean = 1.19 cm2). MVA by PHT ranged from 0.42 to 2.48 cm2 (mean = 1.15 cm2). Color Doppler FCR method provides an accurate estimate of effective mitral valve area and may be useful as an alternative to the pressure half-time method. The calculated mitral valve area by the FCR method is not influenced by the presence of mitral regurgitation nor atrial fibrillation.

Adult↗

PubMedDate not supplied

[Acute myocardial infarct in young adults. A report of 142 cases].

We present 142 cases of myocardial infarction in the young (MIY) which correspond to 5.6% of a total of 2525 patients with MI hospitalized in the past 5 years at the Hospital de Especialidades del Centro Médico La Raza, IMSS. Among them, 124 (87%) were males and 18 (13%) females. The age varied from 25-40 years, average 35 years for both sexes. Occupational labor: 56 (39.5%) were workers, 27 (19%) officemen, 22 (15.5%) professionals, 20 (14%) taxi drivers, 15 (10.5%) merchants and 2 (1.5%) students. Personal cardiac history: 42 (30%) had history of angor pectoris and 5 (3.5%) of MI. Coronary risk factors: 106 patients (75%) had emotional stress due to type "A" personality, 101 (71%) cigarette smoking, 59 (42%) systemic arterial hypertension, 35 (25%) diabetes mellitus, 35 (25%) hyperlipidemias and 28 (20%) obesity. Among them, 34 (24%) had no risk factors. MI localization: 48 (34%) anteroseptal, 37 (26%) anterolateral, 36 (25%) posteroinferior and 21 (15%) inferior. Only in 83 cases coronary angiogram was performed, among them: 34 (41%) had disease of the left coronary artery and 18 (22%) of the right; 33 (40%) had one vessel, 15 (18%) 2 vessel and 4 (5%) 3 vessel disease. In 31 (37%) the coronary angiogram was normal.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMedDate not supplied

[Isolated agenesis of the pulmonary valve in the adult. When is the proper time for surgery?].

The congenital absence of the pulmonary valves is a rare malformation that mainly affects children, frequently is associated with other cardiac malformations and very rarely is present in adults. Elective or urgent surgery is indicated in the symptomatic child; on the other hand, surgical treatment in the asymptomatic adult with this anomaly is controversial. Based on the reported experience in the literature, in the present article, the authors discuss the therapeutic approach of an asymptomatic 22-year-old male with pulmonary valvular absence with practically no hemodynamic repercussion. Although there had been few reported cases of isolated pulmonary valvular absence, the authors concluded that surgery is not a satisfactory solution and that it might be postponed to the time that patients develop congestive heart failure and or respiratory insufficiency. In order to detect that on time, we recommend a follow up based on periodic echocardiographic studies.

Adult↗

PubMedDate not supplied

[Thrombolysis in mechanical prosthetic valve thrombosis. Its management with streptokinase].

We present the first experience in Mexico in 10 patients, 9 female and 1 male with an average age of 42.5 years. All patients had clinical, echocardiographic and fluoroscopic criteria of dysfunctioning mechanical valvular prosthesis due to thrombosis (9 Sorin type and 1 Starr-Edwards). None of the patients had contraindications for thrombolytic therapy. All cases were treated with intravenous streptokinase: 250,000 U in 30 minutes followed by an infusion of 100,000 U per hour, always under clinical, echocardiographic and fluoroscopic control every 2 and 24 hours respectively until the normalization of the clinical and hemodynamic parameters with a top limit of 72 hour. The average duration of the thrombolysis was 54 +/- 6.1 hours with an average total doses of 5' 200,000 U of streptokinase. In 90% of the cases there was an increase in the valvular area: mitral (n = 7), from 1.02 +/- 0.21 to 1.75 +/- 0.36 cm2 (p < 0.001), while the mean transvalvular gradient decreased from 10.42 +/- 3.77 to 3.42 +/- 0.975 mmHg (p < 0.001); the systolic pulmonary artery pressure also decreased from 53.7 +/- 15.29 to 35 +/- 2 mmHg (p < 0.001). In the tricuspid prosthesis (n = 2) the average valvular area was increased from 0.8 +/- 0.44 to 1.55 +/- 0.77 cm2, decreasing proportionally the mean transvalvular gradient from 12.5 +/- 2 to 4.5 +/- 3.5 mmHg with no changes in the systolic pressure of the pulmonary artery. In the Starr-Edwards prosthesis in aortic position (n = 1), no hemodynamic changes were observed.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMedDate not supplied

[Percutaneous mitral commissurotomy using Inoue's balloon during pregnancy].

The authors present three cases of pregnant women with symptomatic severe mitral stenosis with a mean age of 28.6 +/- 2.3 years, and during 27.6 +/- 1.52 weeks of pregnancy. Two patients were in class III and one in class IV of the New York Heart Association (NYHA). All patients had a mitral valvular area equal or less than 1 cm2, with a Wilkins score of 7 to 9 and mitral insufficiency grade I in two cases; two, had severe pulmonary arterial hypertension (mean > 50 mm Hg). After Percutaneous Mitral Valvuloplasty (PMV) the mitral valve measured by 2D echocardiography increased form 0.83 +/- 0.2 cm2 to 1.8 +/- 0.15 cm2; the mean transmitral gradient diminished from 13 +/- 3.4 mm Hg to 3.6 +/- 1.15 mm Hg; the degree of mitral insufficiency was no modified in neither case. Hemodynamic results revealed increasing of the mitral valve from 0.83 +/- 0.18 cm2 to 2.23 +/- 0.3 cm2; the mean mitral gradient decreased from 21.6 +/- 9 to 4.3 +/- 0.5 mm Hg; the mean left atrial pressure from 30 +/- 12 to 12.3 +/- 4 mm Hg; the mean pressure of the pulmonary artery diminished suddenly from 44.3 +/- 16 to 25.6 +/- 11 mm Hg. The average fluoroscopic time was 15.3 +/- 3 minutes. There were no complications. The patients were discharged 48 hours after the procedure and continued their pregnancies in class I NYHA, which resolved in a non complicated vaginal delivery with normal products. We conclude that PMV is a safe and useful therapy in pregnant patient with severe mitral stenosis refractory to medical treatment.

Adult↗

PubMedDate not supplied

[Transrectal recatheterization under echocardiography control].

We present the case of a 36 years-old woman, in whom antegrade mitral intraluminal valvulotomy was performed under transesophageal echocardiography control. Inadvertently, we retired the Inoue's catheter to the right atrium from the left atrium, before the dilation of the mitral valve was accomplished. Under echocardiographic control we reintroduced the transseptal catheter across the former septal orifice, avoiding a new septal puncture, and its possible complications. Now a days, the antegrade intraluminal mitral valvulotomy is easy performed, because the transesophageal echocardiography monitoring. The transesophageal echocardiography has modified the transseptal catheterization contraindications.

Adult↗

PubMedDate not supplied

[Effectiveness of anticoagulant oral treatment in patients with thrombus in left ventricle after acute myocardial infarction].

Left ventricular mural thrombi (LVMT) is a complication of acute myocardial infarction (AMI), that may produce peripheral embolism which could be fatal. In order to establish an adequate time of oral anticoagulant (OA) therapy, we undertook a prospective study that included 45 patients with AMI and left ventricular thrombi detected by echocardiographic study, in the first 5 to 10 days postinfarction, the study was repeated, in 3 and 6 months. Treatment with oral anticoagulant was initiated at the point of the detection of thrombi maintaining an INR of 1.5 to 2. Thirty nine patients (79%) were males and 6 (11%) were females, with an age of 29 to 85 years and a range of 62 +/- 11 years. Forty four patients (98%) presented anterior wall infarction and 1 (2%) posteroinferior infarction. In patients with anterior infarction, in 38 (85%) the thrombi was located at the apical wall (p < 0.05), 5 (11%) in the septal wall and other (2%) in anterior and apical walls. The patient with the posteroinferior infarction presented extension to the right ventricle, where the thrombus was located (2%). The contractility alterations related with thrombi were diskinesia, followed by hipokinesia and finally akinesia. The ejection fraction had not relationship with thrombi formation. LVMT dissolved in 32 patients (71%) at 3 months (p < 0.05), in 8 (18%) in 6 months and in 5 (11%) it was maintained for more than 6 months. None of the patients presented complications of OA. We conclude that the LVMT are more frequent in anterior infarctions, essentially in those that present diskinesia. The majority of LVMT are resolved in 6 months with OA therapy.

Adult↗

PubMedDate not supplied

[Acute myocardial infarction with normal coronary arteries as initial manifestation of polyarteritis nodosa. A case report].

A thirty four-year-old-white man in good health developed an acute anterior wall myocardial infarction (AMI), Killip II with normal coronary arteries. No thrombolytic therapy was given. Selective angiography revealed multiple aneurysms in mesenteric and renal arteries. The diagnosis of polyarteritis nodosa (PAN) was performed. AMI in PAN is secondary to arteritis with thrombosis, or to atherosclerosis due to steroid therapy. This case, having multiorgan vascular aneurysms involvement without previous cardiac symptomatology nor steroid therapy, presented as his first cardiac complication an AMI with normal coronary arteries probably due to selective arteritis.

Adult↗