We present the case of a 62-year-old male who presented with oppressive chest pain and was then diagnosed with acute myocardial infarction and received reperfusion treatment with primary angioplasty. In the evolution, he had a new episode of myocardial infarction, so complementary studies were carried out that led to the diagnosis of Takayasu’s arteritis. Unfortunately, he presented a torpid evolution despite the established management. The clinical presentation in patients older than 60 years is uncommon, so it is important to consider it within the differential diagnosis in patients with diffuse coronary disease and recurrent myocardial ischemia, due to the rapid progression and high morbidity and mortality despite successful revascularization strategies.

Se presenta el caso de un paciente varón de 62 años que cursó con dolor torácico opresivo; fue diagnosticado de infarto agudo de miocardio y recibió tratamiento de reperfusión con angioplastia primaria. En la evolución cursó con un nuevo episodio de infarto de miocardio, por lo que se realizaron estudios complementarios que condujeron al diagnóstico de arteritis de Takayasu. Desafortunadamente, presentó una evolución tórpida a pesar del manejo instaurado. Es infrecuente la presentación clínica en pacientes mayores de 60 años, por ello es importante considerarlo dentro del diagnóstico diferencial en pacientes con enfermedad coronaria difusa e isquemia miocárdica recurrente, debido a la rápida progresión y elevada morbimortalidad, incluso a pesar de estrategias de revascularización exitosas.

Agradecimientos: a la Dirección de la División de Estudios para Ejecutivos (EPE) de la Universidad Peruana de Ciencias Aplicadas (UPC), por facilitar el acceso a su población de estudiantes. Al Vicerrectorado de Investigación de la UPC por el apoyo para la redacción del presente artículo. Al médico Vicente Benites-Zapata (Instituto Nacional de Salud, Lima, Perú) por su revisión y sugerencias.

We present the case of a 62-year-old male who presented with oppressive chest pain and was then diagnosed with acute myocardial infarction and received reperfusion treatment with primary angioplasty. In the evolution, he had a new episode of myocardial infarction, so complementary studies were carried out that led to the diagnosis of Takayasu’s arteritis. Unfortunately, he presented a torpid evolution despite the established management. The clinical presentation in patients older than 60 years is uncommon, so it is important to consider it within the differential diagnosis in patients with diffuse coronary disease and recurrent myocardial ischemia, due to the rapid progression and high morbidity and mortality despite successful revascularization strategies.

Modalidad de obtención de segunda especialidad sin designación de jurado según Oficio N.° 009-2025–OGYT-FMH/USMP

Objective. To characterize compliance with the annual curricular program of second and third-year cardiology residents in hospital of Lima—Peru during the COVID-19 pandemic. Materials and methods. A cross-sectional study was conducted, through a questionnaire applied to seventy-eight cardiology residents from the second and third year of specialty. We evaluated the compliance with rotations in clinical fields, individual compliance with the annual program, and the achievement of minimum training standards. Results. Compliance with rotations in clinical fields was highly variable (from 7.9% in Cardiac Rehabilitation for the second year to 90.9% for imaging in cardiology). Regarding individual compliance, 98.7% did not manage to comply with the annual program. Finally, only the standard of evaluation by radionuclides of myocardial function and perfusion was achieved by all residents, con...

Objective: To determine the prevalence of coronary anomalies (CA) in patients evaluated by 64-detector computed tomography (CT) at the Instituto Nacional Cardiovascular in Peru between 2016 and 2020. Materials and methods: Retrospective observational study, coronary artery CT scans of 1486 patients were performed on a 64-detector row CT scanner and reviewed in search for coronary anomalies. Results: The prevalence of CA detected by CT was 4.71% (70 cases) of which 64.3% were male. Abnormalities of origin were the most frequent, of which the origin of a coronary artery from the opposite coronary sinus was the most common (48.6%), with the right coronary being the main anomalous artery (31%), and the main path was interarterial (31%). Anomalous origin of the left main coronary from the pulmonary artery was found in 5 patients. Among the anomalies of the intrinsic coronary arterial anatomy ...

Objetivo. Evaluar si existe asociación entre la alexitimia y el riesgo de trastornos de conducta alimentaria (RTCA) controlado por variables sociodemográficas, académicas y clínicas en una población de mujeres adolescentes que estudian en colegios públicos en Lima, Perú.. Métodos. Realizamos un estudio transversal analítico en mujeres entre 12 a 17 años que cursan estudios secundarios en Lima, Perú. Mediante la Toronto Alexithymia Scale (TAS 20) definimos tres categorías: sin alexitimia, posible alexitimia, y con alexitimia. Con el Eating Attitudes Test (EAT-26) definimos RTCA. Asimismo, medimos la edad, nivel de estudios, residencia, consumo de tabaco, consumo de alcohol, tipo de colegio, autoestima, riesgo de ansiedad y riesgo de depresión. Calculamos razones de prevalencia con intervalo de confianza al 95% [RP (IC95%)] mediante modelos lineales generalizados familia Poiss...

Objective. To characterize compliance with the annual curricular program of second and third-year cardiology residents in hospital of Lima—Peru during the COVID-19 pandemic. Materials and methods. A cross-sectional study was conducted, through a questionnaire applied to seventy-eight cardiology residents from the second and third year of specialty. We evaluated the compliance with rotations in clinical fields, individual compliance with the annual program, and the achievement of minimum training standards. Results. Compliance with rotations in clinical fields was highly variable (from 7.9% in Cardiac Rehabilitation for the second year to 90.9% for imaging in cardiology). Regarding individual compliance, 98.7% did not manage to comply with the annual program. Finally, only the standard of evaluation by radionuclides of myocardial function and perfusion was achieved by all residents, con...

Objetivo. Caracterizar el cumplimiento del programa curricular anual de los médicos residentes de cardiología de segundo y tercer año en hospitales de la ciudad de Lima - Perú durante la pandemia COVID-19. Materiales y métodos. Se realizó un estudio transversal, mediante un cuestionario aplicado a 78 residentes de cardiología del segundo y tercer año de especialidad. Se evaluó el cumplimiento de rotaciones en campos clínicos, cumplimiento individual del programa anual de rotaciones y el logro de estándares mínimos de formación. Resultados. El cumplimiento de las rotaciones en campos clínicos fue muy variable (desde 7,9% en rehabilitación cardiaca para segundo año, hasta un 90,9% para imágenes en cardiología). En cuanto al cumplimiento individual, el 98,7% no alcanzó a cumplir el programa anual. Finalmente, solo el estándar de evaluación mediante radionúclidos de la ...

Objective: To determine the prevalence of coronary anomalies (CA) in patients evaluated by 64-detector computed tomography (CT) at the Instituto Nacional Cardiovascular in Peru between 2016 and 2020. Materials and methods: Retrospective observational study, coronary artery CT scans of 1486 patients were performed on a 64-detector row CT scanner and reviewed in search for coronary anomalies. Results: The prevalence of CA detected by CT was 4.71% (70 cases) of which 64.3% were male. Abnormalities of origin were the most frequent, of which the origin of a coronary artery from the opposite coronary sinus was the most common (48.6%), with the right coronary being the main anomalous artery (31%), and the main path was interarterial (31%). Anomalous origin of the left main coronary from the pulmonary artery was found in 5 patients. Among the anomalies of the intrinsic coronary arterial anatomy ...

Objetivo: determinar la prevalencia de anomalías coronarias (AC) en pacientes evaluados por tomografía computarizada (TC) de 64 detectores en el Instituto Nacional Cardiovascular en el Perú entre los años 2016 a 2020. Materiales y métodos: estudio observacional retrospectivo, en el cual se revisaron las TC de arterias coronarias de 1486 pacientes, realizadas en un tomógrafo de 64 filas de detectores, en busca de anomalías coronarias. Resultados: la prevalencia de AC detectada por TC fue de 4,71% (70 casos) de ellos 64,3% varones. Las anomalías de origen fueron las más frecuentes, de ellas el nacimiento de una arteria coronaria desde el seno coronariano opuesto fue la más común (48,6%), siendo la coronaria derecha la principal arteria anómala (31%), y el principal trayecto fue el interarterial (31%). El origen anómalo del tronco coronario izquierdo desde la arteria pulmonar s...

The definition of high-risk chronic coronary syndrome varies depending on the noninvasive test used to trigger ischemia. The triggering occurs through increased myocardial work and oxygen demand, either through exercise or drugs. The initial approach to the chronic coronary syndrome leads us to discuss in which cases to prioritize an optimal initial medical therapy or to perform an initial invasive procedure of myocardial revascularization. In this article we analyze both approaches based on previous studies carried out to date, where the initial invasive management has not been shown to be superior to initial optimal medical therapy in outcomes such as death or major adverse cardiovascular events.

La definición de síndrome coronario crónico de alto riesgo varía según la prueba no invasiva empleada para evidenciar isquemia, lo que se consigue a través de un aumento del trabajo miocárdico y la demanda de oxígeno, generados con el uso de fármacos o el ejercicio. El abordaje inicial nos sumerge en la discusión de contextualizar en qué casos priorizar la terapia médica óptima inicial, frente al manejo invasivo inicial con el objetivo de lograr la revascularización miocárdica. Este aspecto central será desarrollado en esta revisión, tomando en cuenta diversos estudios realizados hasta la fecha, en los que el manejo invasivo inicial no ha demostrado ser superior a la terapia médica óptima inicial en resultados clínicos relevantes como muerte o eventos adversos cardiovasculares mayores.

The definition of high-risk chronic coronary syndrome varies depending on the noninvasive test used to trigger ischemia. The triggering occurs through increased myocardial work and oxygen demand, either through exercise or drugs. The initial approach to the chronic coronary syndrome leads us to discuss in which cases to prioritize an optimal initial medical therapy or to perform an initial invasive procedure of myocardial revascularization. In this article we analyze both approaches based on previous studies carried out to date, where the initial invasive management has not been shown to be superior to initial optimal medical therapy in outcomes such as death or major adverse cardiovascular events.

Las fístulas de arterias coronarias son entidades clínicas infrecuentes y su asociación con aneurismas coronarios gigantes, es aún más inusual. La mayoría de las fístulas son asintomáticas, por otro lado, los aneurismas podrían desarrollar síntomas según su diámetro. Presentamos el caso clínico, de un paciente con dolor torácico y arresto cardíaco, que posteriormente desarrolló taponamiento cardíaco con necesidad de cirugía de emergencia, por ruptura de aneurisma coronario gigante desarrollado a partir de fístulas de arterias coronarias confluentes desde dos arterias coronarias hacia la arteria pulmonar.

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Coronary artery fistulas are rare clinical entities, and their association with giant coronary aneurysms is even more unusual. Most fistulas are asymptomatic, in the other hand, aneurysms could develop symptoms depending on their diameter. We present the clinical case about a patient with chest pain and cardiac arrest, who later developed cardiac tamponade with the need for emergency surgery, due to rupture of a giant coronary aneurysm developed from confluent coronary artery fistulas from two coronary arteries to pulmonary artery.

Coronary artery fistulas are rare clinical entities, and their association with giant coronary aneurysms is even more unusual. Most fistulas are asymptomatic, in the other hand, aneurysms could develop symptoms depending on their diameter. We present the clinical case about a patient with chest pain and cardiac arrest, who later developed cardiac tamponade with the need for emergency surgery, due to rupture of a giant coronary aneurysm developed from confluent coronary artery fistulas from two coronary arteries to pulmonary artery.