Rev Esp Cardiol
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Comparative Study
[Analysis of causes of excessive prehospital delay of patients with acute myocardial infarction in the province of Teruel].
To analyze the delay of patients who come to the hospital and are diagnosed with acute myocardial infarction, its causes and the variables with determine it. ⋯ The pre-hospital delay detected in our environment is longer than other studies and confirms that half of it is not due to the intrinsic functioning of our health system, even through it should get involved as much as possible to diminish the delay time.
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Minimally invasive surgery is being applied to certain procedures in cardiac surgery. Aortic valve replacement presents the highest number of cases in which this approach is feasible. ⋯ A transverse incision at the level of the second intercostal space provides an excellent exposure for aortic valve replacement. Surgical times are not excessively prolonged and patient's recovery is faster and less painful than with the standard midline sternotomy.
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Review Case Reports
[The usefulness of transesophageal echocardiography in the diagnosis of atypical aortic coarctation].
We report the case of a 20-year-old woman with severe hypertension diagnosed two months previously. The symptoms and physical examination suggested the diagnosis of coarctation of the aorta, but a transthoracic echocardiogram and a thoracic CT scan were normal. Nevertheless, a severe stenosis of the thoracoabdominal aorta was demonstrated by transesophageal echocardiography. The usefulness of transesophageal echocardiography for the diagnosis of atypical coarctation of the aorta is discussed.
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Case Reports
[Extrinsic compression of the left atrium as an infrequent and fatal form of type B aortic dissection: value of ECG].
We present an infrequent case of extrinsic compression of the left atrium caused by a type B aortic dissection diagnosed by echocardiography. The transthoracic echocardiography showed the obliteration of the left atrium by a heterogeneous mass with two circular images of low echogenicity. The TEE study identified the mass as a huge hematoma surrounding the true and false lumen of the aneurysm. The case demonstrated the value of echocardiography in the diagnosis of type B aortic dissection.
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The evidence supporting the use of beta-adrenergic blockers in the treatment of heart failure secondary to systolic dysfunction is reviewed. Up to date, seven controlled trials of carvedilol in patients with heart failure have been published. ⋯ It seems logical to wait for the results of the ongoing trials (BEST Trial, CIBIS II Trial, COMET Trial, and MERIT Trial) to more precisely define the role that beta-adrenergic blockers should play in the treatment of patients with heart failure. The information presently available suggests that carvedilol should be considered a therapeutic agent for the prevention of progressive clinical heart failure rather than for the treatment of refractory heart failure.