Nuria Casanovas

Effects of Helicobacter pylori eradication on platelet activation and disease recurrence in patients with acute coronary syndromes.

Background.  Platelet activation is consistently observed in animal models of Helicobacter pylori infection and could help to explain the alleged epidemiological association between H. pylori and coronary heart disease.

Pronóstico a largo plazo de las mujeres con síndrome coronario agudo sin elevación del segmento ST

Antecedentes y objetivos. Las mujeres con infarto y elevacion del segmento ST tienen un peor pronostico que los varones. Sin embargo, existe poca informacion sobre el pronostico de las mujeres con sindrome coronario agudo sin elevacion del segmento ST (SCASEST). El objetivo del estudio fue conocer si el pronostico a largo plazo de las mujeres con SCASEST es diferente al de los varones. Pacientes y metodo. De un total de 300 pacientes consecutivos ingresados por SCASEST con cambios isquemicos en el ECG, se compararon las caracteristicas clinicas y la evolucion de las 95 mujeres con las de 95 varones seleccionados por tener la misma edad, prevalencia de diabetes mellitus e hipertension arterial.

Complete Atrioventricular Block Secondary to Pulmonary Embolism

We describe a 73-year-old woman with a history of breast cancer and metastatic disease diagnosed in January 2002 (stable when we saw her) who was admitted for sudden dyspnea and presyncope. Complete atrioventricular block was documented, and a temporary pacemaker was implanted. Eight hours after admission she recovered sinus rhythm with left bundle branch block as seen in previous recordings. Computed tomography showed bilateral pulmonary thromboembolism. An electrophysiological study showed normal atrioventricular conduction. We suggest that in this patient, who had previous left bundle branch block, pulmonary thromboembolism may have induced transient right bundle branch block, which in turn caused atrioventricular block.

Trombosis intracardíaca y síndrome antifosfolípido primario. Un caso familiar

El sindrome antifosfolipido es una entidad clinica poco frecuente que se manifiesta por fenomenos tromboticos de repeticion en pacientes jovenes sin factores de riesgo cardiovascular. Sus formas de presentacion son multiples, pero las mas frecuentes son las perdidas fetales de repeticion y el accidente cerebrovascular. La afeccion cardiaca es menos frecuente. Describimos un caso familiar que se ha presentado con trombosis intracardiaca y embolia cerebral secundaria.

Bloqueo auriculoventricular completo secundario a tromboembolia pulmonar

Paciente de 73 anos, con antecedentes de neoplasia de mama y enfermedad metastasica diagnosticada en enero de 2002, estable actualmente. Ingresa por disnea subita y sensacion presincopal; se documenta la existencia de un bloqueo auriculoventricular completo, que requiere la implantacion de marcapasos temporal. A las 8 h recupera el ritmo sinusal con bloqueo de rama izquierda ya conocido. Una tomografia computarizada demuestra la existencia de una tromboembolia pulmonar bilateral. Un estudio electrofisiologico muestra conduccion auriculoventricular normal. Sugerimos que en presencia de bloqueo de rama izquierda, una tromboembolia pulmonar, que pudo cursar con bloqueo de rama derecha transitorio, provoco este bloqueo completo paroxistico.

Reduction in door-to-needle time to meet clinical guideline recommendations. Outcomes after 1 year.

The aim of this study was to reduce the door-to-needle time in patients with ST-elevation acute myocardial infarction by setting up a chest pain service. We compared the door-to-needle time and outcomes at the end of first year of follow-up in patients who received fibrinolysis in the 2 years before implementation of the service (Group 1) and those who received fibrinolysis in the 2 years after its creation (Group 2). In Group 1, the median door-to-needle time was 40 min (P(25-75), 23-52 min); in Group 2, it was 27 min (P(25-75), 15-43 min; P=.003). In addition, the use of reperfusion therapy increased from 55.2% in Group 1 to 64.7% in Group 2 (P< .01). After a follow-up period of 1 year, there was no difference in the rate of revascularization, hospital readmission, reinfarction or cardiovascular mortality.