Archivos de cardiología de México
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The ion channel diseases of the heart are a collection of genetically distinct arrhythmogenic cardiovascular disorders resulting from mutations in fundamental cardiac ion channels that orchestrate the action potential of the human heart. Our understanding of these genetic "channelopathies" has increased dramatically from electrocardiographic depictions of QT prolongations, ST-T alterations and torsades de pointes and clinical descriptions of people experiencing syncope and sudden death to molecular revelations of perfurbed ion channel genes. These exciting molecular breakthroughs have provided new opportunities for translational research with investigations into genotype-phenotype correlations and gene targeted therapies.
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Radiofrequency catheter ablation has emerged as a curative therapy for atrial flutter based on studies demonstrating the role of the cavotricuspid isthmus. With a high rate of success and minimal complications, catheter ablation is the therapy of choice for patients with the common type of atrial flutter. Left atrial flutter, non-cavotricuspid isthmus dependent, and those associated with heart disease have a worst outcome with catheter ablation. ⋯ Mapping is guided by special catheters. Sequential radiofrequency applications eliminates or dissociates pulmonary vein muscle activity. Although complications exists, this is the only curative method for these patients.
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Review Practice Guideline Comparative Study Guideline
[Mexican Cardiology Society Guidelines on the management of patients with unstable angina and non-ST-segment elevation myocardial infarction. Cancún, Quintana Roo 15-16 November 2002. Cooperative Group of Consensus].
Mexican Cardiology Society guidelines for the Management of patients with unstable angina and non-ST--segment elevation myocardial infarction are presented. The Mexican Society of Cardiology has engaged in the elaboration of these guidelines in the area of acute coronary syndromes based on the recent report of RENASICA [National Registry of Acute Coronary Syndromes]: 70% of the ACS correspond to patients with unstable angina and non-ST--segment elevation myocardial infarction seen in the emergency departments during the years 1999-2001 in hospitals of 2nd and 3rd level of medical attention. Experts in the subject under consideration were selected to examine subject-specific data and to write guidelines. ⋯ These guidelines represent an attempt to define practices that meet the needs of most patients in most circumstances in Mexico. The ultimate judgment regarding the care of a particular patient must be made by the physician and patient in light of all of the available information and the circumstances presented by that patient. The present guidelines for the management of patients with unstable angina and non-ST--segment elevation myocardial infarction should be reviewed in the next coming future by Mexican cardiologists according to the forthcoming advances in ACS without ST-segment elevation.
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The Hypertensive Crisis can be divided into Emergencies and Urgencies. Hypertension may be unknown at presentation. The Emergencies have acute or ongoing end-organ damage (neurological, renal or cardiovascular). ⋯ The general recommendation is to reduce the mean arterial pressure gradually in the first 48 hours by no more than 20 percent or to a diastolic blood pressure not lower than 100 mmHg. A relatively asymptomatic patient, even with high diastolic lectures does not need to be treated with parenteral drugs. The patient should be evaluated for possible factors that may have contributed to the high of blood pressure and the progression of hypertension.
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A 33 year-old man developed coccidioidomycosis which resulted in pericarditis associated with congestive heart failure. A pericardial effusion developed and progressed to constrictive pericarditis. ⋯ The patient died after surgery. This is the second case of coccidioidomycosis with pericarditis reported in Mexico's literature.