Antonio Espolita

Espasmo coronario y parada cardíaca por fibrilación ventricular

Se presentan los casos de 3 varones jovenes, fumadores severos y sin cardiopatia conocida, que sobrevivieron a una parada cardiaca por fibrilacion ventricular secundaria a un espasmo coronario. Todos ellos presentaban previamente dolor toracico atipico y la ergometria, ecocardiograma y estudio angiografico coronario fueron normales. Al diagnostico final de espasmo coronario se llego por metodos diferentes: en el primero de ellos, mediante monitorizacion electrocardiografica de 24 h y test de provocacion con ergonovina intracoronaria; en el segundo, mediante test de provocacion con acetilcolina intracoronaria y en el ultimo mediante monitorizacion electrocardiografica de 24 h. Tras tratamiento con nitratos y/o calcioantagonistas permanecieron posteriormente asintomaticos.

Grado de conocimiento de stents coronarios, trombosis y doble antiagregación entre los odontólogos en España

Introduction and objectives. The coexistence of heart and dental disease is common and antiplatelet therapy with aspirin and clopidogrel following a percutaneous intervention can interfere with dental practice. Our aim was to study dentists’ knowledge of percutaneous coronary interventions and their approach to affected patients. Methods. A questionnaire was used to evaluate the knowledge of 100 randomly selected dentists in Spain about coronary stents, antiplatelet therapy, and guidelines prepared by American medical societies, including the American Dental Association, and to determine how frequently they consulted a cardiologist. Results. Data were collected from 100 dentists. Of these, 17 had no knowledge of coronary stents, but only one did not interrupt dual therapy: 12 consulted a cardiologist and the remaining four discontinued therapy themselves. Of the 83 who knew about stents, only 28 (34%) understood the difference between bare metal and drug-eluting stents. The drug clopidogrel’s name was known by 21%, while 60% recognized one of the drug’s commercial names and 45% recognized the other. Of the 83 aware of stents, 48 (58%) knew of the possibility of stent thrombosis, but only three knew about possible mortality. Cardiologists were consulted before dental procedures in 83% of cases. Only 36% knew about the existence of the guidelines. Conclusions. Although Spanish dentists’ knowledge of coronary interventions was limited, in the majority of cases a cardiologist was consulted before a patient taking dual antiplatelet therapy was treated. Only a small percentage of those questioned knew of the existence of American medical society guidelines.