RESUMO
OBJECTIVE: To identify differences between both genders regarding coronary artery disease occurrence. PATIENTS AND METHODS: In referred patients for cardiac catheterization we investigated coronary risk factors, clinical diagnosis, associated diseases, left ventricle ejection fraction, and coronary lesions. Data were analyzed by X2 test, Student t test, odds ratio and confidence intervals, a p value < 0.05 was considered significant. RESULTS: We studied 586 patients, 409 were men. Women were older than men (59.43 +/- 9.93 vs 56.80 +/- 10.14 years old, p < 0.05). The frequency of coronary lesions in women was 56 vs 81% in men. The proportions of positive nuclear medicine studies (14 vs 16%) and exercise treadmill test (36 vs 28%) were similar. Acute myocardial infarction was the most frequent diagnosis in men (46%) whereas in women it was angor pectoris (57%). Smoking was observed more in men (72 vs 26%) and systemic arterial hypertension in women (65 vs 48%), There were no differences in diabetes mellitus and dyslipidemia frequencies. CONCLUSION: Systemic arterial hypertension was the risk factor more frequent in women, where as in men it was smoking. Ischemia induction tests are less specific to identify coronary atherosclerosis in women. In spite of the clinical data, image and laboratory results, we had a great proportion of women without coronary lesions.
Assuntos
Doença da Artéria Coronariana/diagnóstico , Feminino , Humanos , Masculino , México , Pessoa de Meia-Idade , Isquemia Miocárdica/diagnóstico , Fatores SexuaisRESUMO
OBJECTIVE: To identify differences between both genders regarding coronary artery disease occurrence. PATIENTS AND METHODS: In referred patients for cardiac catheterization we investigated coronary risk factors, clinical diagnosis, associated diseases, left ventricle ejection fraction, and coronary lesions. Data were analyzed by X2 test, Student t test, odds ratio and confidence intervals, a p value < 0.05 was considered significant. RESULTS: We studied 586 patients, 409 were men. Women were older than men (59.43 +/- 9.93 vs 56.80 +/- 10.14 years old, p < 0.05). The frequency of coronary lesions in women was 56 vs 81% in men. The proportions of positive nuclear medicine studies (14 vs 16%) and exercise treadmill test (36 vs 28%) were similar. Acute myocardial infarction was the most frequent diagnosis in men (46%) whereas in women it was angor pectoris (57%). Smoking was observed more in men (72 vs 26%) and systemic arterial hypertension in women (65 vs 48%), There were no differences in diabetes mellitus and dyslipidemia frequencies. CONCLUSION: Systemic arterial hypertension was the risk factor more frequent in women, where as in men it was smoking. Ischemia induction tests are less specific to identify coronary atherosclerosis in women. In spite of the clinical data, image and laboratory results, we had a great proportion of women without coronary lesions.
Assuntos
Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doença da Artéria Coronariana , México , Isquemia Miocárdica , Fatores SexuaisRESUMO
Atherosclerosis is the most frequent etiology of ischemic cardiopathy. At the present time, the scope of nonatherosclerotic coronary artery lesions has increased, in part, because collagen diseases affecting the epicardial or microcirculation of the coronary arteries are more frequently diagnosed during catheterization. Acquired nonatherosclerotic coronary artery diseases may occur as a primary abnormality or as part of a multisystem disorder and may mimic atherosclerotic disease. In this paper we present a review of the main collagen diseases that cause coronary artery lesions.
Assuntos
Doença da Artéria Coronariana/diagnóstico , HumanosRESUMO
Shunt and short circuit are antonyms. In French, the term shunt has been adopted to denote the alternative pathway of blood flow. However, in French, as well as in Spanish, the word short circuit (court-circuit and cortocircuito) is synonymous with shunt, giving rise to a linguistic and scientific inconsistency. Scientific because shunt and short circuit made reference to a phenomenon that occurs in the field of the physics. Because shunt and short circuit are antonyms, it is necessary to clarify that shunt is an alternative pathway of flow from a net of high resistance to a net of low resistance, maintaining the stream. Short circuit is the interruption of the flow, because a high resistance impeaches the flood. This concept is applied to electrical and cardiovascular physiology, as well as to the metabolic pathways.
Assuntos
Fluxo Sanguíneo Regional , Terminologia como Assunto , Humanos , Fluxo Sanguíneo Regional/fisiologiaRESUMO
The authors present the case of a 54-year-old woman with iatrogenic dissection of the right coronary artery ostium and extension of the dissection to the ascending aorta during the intraluminal angioplasty of an obstructive lesion in the middle portion of the right coronary artery. In order to maintain coronary blood flow before surgery, the coronary dissection was treated with the implantation of three direct coronary stents that dilated the stenosis and sealed the dissection of the coronary artery. The aortic dissection needed treatment with the implantation of a Haenoshield aortic graft. During the surgery, it was decided to implant an aortocoronary bypass graft to guarantee the distal right coronary blood flow, given the possible increased risk of thrombosis of the stents because of the large thrombogenic metallic surface of the stents. On the other hand, the administration of anticoagulants and antithrombotic drugs were not indicated because of the intended surgery of the aortic dissection. The evolution of the patient was satisfactory. Causes, frequency, and treatment procedures of this iatrogeny are discussed.
Assuntos
Angioplastia Coronária com Balão/efeitos adversos , Aorta/lesões , Vasos Coronários/lesões , Aorta/cirurgia , Aortografia , Prótese Vascular , Angiografia Coronária , Ponte de Artéria Coronária , Circulação Coronária , Estenose Coronária/terapia , Vasos Coronários/cirurgia , Feminino , Seguimentos , Humanos , Doença Iatrogênica , Pessoa de Meia-Idade , Stents , Fatores de Tempo , Tomografia Computadorizada por Raios X , Resultado do TratamentoAssuntos
Atitude Frente a Morte , Características Culturais , Religião , Arqueologia/história , Europa (Continente) , História do Século XV , História do Século XVI , História do Século XIX , História do Século XX , História Antiga , História Medieval , Humanos , Indígenas Norte-Americanos/história , México , Religião/história , Escultura/história , SuicídioRESUMO
OBJECTIVE: The authors studied the sensitivity and specificity, as well the positive and negative predictive values, of a prognostic index conformed by diastolic blood pressure, total number of cigarettes smoked during the lifetime, severity of angina pectoris, positive family history of ischemic heart diseases, age (years), current cigarette smoking, and total to HDL-cholesterol ratio in order to anticipate the presence of significant coronary artery disease in patients with rheumatic cardiac valvulopathy. MATERIAL AND METHODS: A prospective, observational, non-randomized, cross-sectional and comparative study was performed in men and women > or = 30 and < or = 78 years of age, with rheumatic valve cardiopathy and who were submitted to catheterization and coronary angiography. RESULTS: We studied 102 patients (61 women and 41 men) 55.63 +/- 9.88 years of age, range: 30-78 years (women 56.09 +/- 11.48, and men 54.6 +/- 11.35 years of age, respectively). The patients had mitral valve disease 30 (29.41%), 49 (48.03%) had mitral valve disease associated with aortic valve disease and 23 (22.55%) had aortic valvular disease. Significant coronary artery atherosclerosis was present in eight patients (7.84%). Sensitivity and specificity analysis resulted as follows: sensitivity, 50% and specificity, 80.85%. Positive predictive value was 0.18 and negative predictive value 0.95. CONCLUSIONS: The index analyzed here is useful to predict cases without significant coronary artery disease in patients with rheumatic heart valvulopathy, but this index is not useful to identify significant coronary artery disease in such patients.