Desde su primera descripción el Sindrome de Brugada ha despertado gran interés científico como causa de muerte súbita. Presentamos el caso de un varón de 45 años quien ingresó al hospital en arresto cardiaco y en su evolución se le diagnosticó Sindrome de Brugada lográndose el implante de un cardiodesfibrilador como opción terapéutica definitiva. Resaltamos la importancia de reconocer el patrón electrocardiográfico característico y de considerar esta canalopatía en el diagnóstico diferencial de muerte súbita.

Homozygous familial hypercholesterolemia (HFH) is a rare and life-threatening disease that can manifest as coronary artery disease or severe aortic stenosis before twenties. We present the case of a male adolescent who was hospitalized with a clinical diagnosis of HFH and severe aortic stenosis. He underwent aortic valve replacement with mechanical prosthesis and aortic annulus enlargement, and two aortocoronary bypasses were implanted due to an intraoperative complication. The patient evolved favourably and was discharged with combination therapy with high-intensity statins and ezetimibe.

Homozygous familial hypercholesterolemia (HFH) is a rare and life-threatening disease that can manifest as coronary artery disease or severe aortic stenosis before twenties. We present the case of a male adolescent who was hospitalized with a clinical diagnosis of HFH and severe aortic stenosis. He underwent aortic valve replacement with mechanical prosthesis and aortic annulus enlargement, and two aortocoronary bypasses were implanted due to an intraoperative complication. The patient evolved favourably and was discharged with combination therapy with high-intensity statins and ezetimibe.

La hipercolesterolemia familiar homocigota (HFH) es una enfermedad infrecuente y potencialmente mortal que se puede manifestar como enfermedad coronaria o estenosis aórtica severa antes de los 20 años de edad. Presentamos el caso de un adolescente de sexo masculino que fue hospitalizado con diagnóstico clínico de HFH y estenosis aórtica severa. Se le realizó cirugía de reemplazo de válvula aórtica con prótesis mecánica y ampliación de anillo, y se implantaron dos baipases aortocoronarios debido a una complicación intraoperatoria. El paciente evolucionó favorablemente y fue dado de alta con terapia combinada con estatinas de alta intensidad y ezetimibe.

ST-segment elevation myocardial infarction (STEMI) is a clinical entity whose adequate treatment will depend on its prompt recognition, accurate diagnosis, and management in reperfusion networks. The first contact with these patients is generally done in centers without reperfusion capacity, attended by non-cardiologist doctors, and in centers far from hospitals with greater resolution capacity, something that is well known in our country. This manuscript proposes a strategy for the diagnosis and treatment of STEMI in centers without percutaneous coronary intervention capacity of the public health system in Peru, emphasizing not losing sight of electrocardiographic patterns compatible with coronary artery occlusion, adequate fibrinolysis and management of its complications, the treatment of infarction in special populations and highlighting the importance of the pharmacoinvasive strategy...

El infarto de miocardio con elevación del segmento ST (IMCEST) es una entidad clínica cuyo tratamiento adecuado dependerá de su pronto reconocimiento, diagnóstico certero y manejo en redes de reperfusión. El primer contacto con estos pacientes es generalmente en centros sin capacidad de reperfusión, atendidos por médicos no cardiólogos y en centros alejados de hospitales de mayor capacidad resolutiva, algo que es bien conocido en nuestro país. Este manuscrito propone la estrategia de diagnóstico y tratamiento del IMCEST para centros sin capacidad de intervención coronaria percutánea del sistema público de salud en el Perú, haciendo hincapié en no perder de vista patrones electrocardiográficos compatibles con oclusión de la arteria coronaria, fibrinolisis adecuada y manejo de sus complicaciones, el tratamiento del infarto en poblaciones especiales y resaltando la importan...

ST-segment elevation myocardial infarction (STEMI) is a clinical entity whose adequate treatment will depend on its prompt recognition, accurate diagnosis, and management in reperfusion networks. The first contact with these patients is generally done in centers without reperfusion capacity, attended by non-cardiologist doctors, and in centers far from hospitals with greater resolution capacity, something that is well known in our country. This manuscript proposes a strategy for the diagnosis and treatment of STEMI in centers without percutaneous coronary intervention capacity of the public health system in Peru, emphasizing not losing sight of electrocardiographic patterns compatible with coronary artery occlusion, adequate fibrinolysis and management of its complications, the treatment of infarction in special populations and highlighting the importance of the pharmacoinvasive strategy...

  Background. ST-segment elevation myocardial infarction (STEMI), is an important cause of morbidity and mortality worldwide, and myocardial reperfusion, when adequate, reduces the complications of this entity. The aim of the study was to describe the clinical and treatment characteristics of STEMI in Peru and the relationship of successful reperfusion with in-hospital adverse events. Materials and methods. Prospective, multicenter cohort of STEMI patients attended during 2020 in public hospitals in Peru. We evaluated the clinical, therapeutic characteristics and in-hospital adverse events, also the relationship between successful reperfusion and adverse events. Results. A total of 374 patients were included, 69.5% in Lima and Callao. Fibrinolysis was used in 37% of cases (pharmacoinvasive 26% and alone lysis 11%), primary angioplasty with < 12 hours of evolution in 20%, late ang...

La combinación de regurgitación valvular aórtica, aortitis y estenosis sub aórtica no es frecuente en pacientes con artritis reumatoide. Además, el tratamiento quirúrgico de estas entidades puede ser desafiante y con resultados inadecuados. En este trabajo reportamos el caso de una paciente con regurgitación aórtica severa, raíz aórtica de inaccesible abordaje secundaria a aortitis reumatoide, y estenosis sub aórtica tratada en primera instancia con reemplazo valvular aórtico. Reoperamos a la paciente debido a una falla protésica aguda y se efectuó una reconstrucción valvular aórtica con pericardio bovino siguiendo la técnica de Ozaki con buenos resultados

  Background. ST-segment elevation myocardial infarction (STEMI), is an important cause of morbidity and mortality worldwide, and myocardial reperfusion, when adequate, reduces the complications of this entity. The aim of the study was to describe the clinical and treatment characteristics of STEMI in Peru and the relationship of successful reperfusion with in-hospital adverse events. Materials and methods. Prospective, multicenter cohort of STEMI patients attended during 2020 in public hospitals in Peru. We evaluated the clinical, therapeutic characteristics and in-hospital adverse events, also the relationship between successful reperfusion and adverse events. Results. A total of 374 patients were included, 69.5% in Lima and Callao. Fibrinolysis was used in 37% of cases (pharmacoinvasive 26% and alone lysis 11%), primary angioplasty with < 12 hours of evolution in 20%, late ang...