A 31- year-old woman in the thirty-four week of her second pregnancy was admitted with diffuse sudden-onset abdominal pain. Examination revealed cervical dilation to 7 cm and transverse presentation of the fetus,indications for emergency cesarean section, which was performed uneventfully under spinal anesthesia. Two days after surgery the patient presented signs consistent with acute pulmonary edema. Echocardiography demonstrated left ventricular systolic dysfunction with an ejection fraction of 32%. The diagnosis was peripartum myocardiopathy with acute respiratory insufficiency due to heart failure. Furosemide and captopril were prescribed and the outcome was satisfactory. The discharge echocardiogram showed a left ventricle of normal size and thickness, and the ejection fraction was 50%. Peripartum myocardiopathy is a type of heart failure that develops during the third trimester or d...

A 31- year-old woman in the thirty-four week of her second pregnancy was admitted with diffuse sudden-onset abdominal pain. Examination revealed cervical dilation to 7 cm and transverse presentation of the fetus,indications for emergency cesarean section, which was performed uneventfully under spinal anesthesia. Two days after surgery the patient presented signs consistent with acute pulmonary edema. Echocardiography demonstrated left ventricular systolic dysfunction with an ejection fraction of 32%. The diagnosis was peripartum myocardiopathy with acute respiratory insufficiency due to heart failure. Furosemide and captopril were prescribed and the outcome was satisfactory. The discharge echocardiogram showed a left ventricle of normal size and thickness, and the ejection fraction was 50%. Peripartum myocardiopathy is a type of heart failure that develops during the third trimester or d...

Objetives: To determine the frequency of clinical entities associated with inhalation cocaine use in a Peruvian population. Design: Prospective, descriptive, series of cases type study. Setting: Hospital Edagrdo Rebagliati Martins, EsSalud, teaching hospital, and Clinica San Felipe. Participants: Patients attended from 1991 through 2006. Main outcome measures: Symptoms and clinical entities associated to nasal cocaine use. Results: In 63 patients evaluated, median age was 35 years; 53 (84%) were male, 96% had previously used cocaine. Symptoms appeared before 2 hours lapse in 78%; 81% had abnormal electrocardiograms. Reported symptoms were chest pain (59%), palpitations (27%), convulsive crisis (5%), hypertermia (3%) and headache (6%). Associated clinical entities were acute coronary syndromes (49%), ventricular arrythmia (25%), myocardial infarction (10%), hypertensive crisis (5%), and d...

Estudio que tiene como objetivo conocer la frecuencia de entidades clínicas cardiovasculares asociadas al empleo de cocaína por vía nasal en consumidores peruanos. Se hizo un estudio prospectivo, descriptivo, tipo serie de casos, con pacientes del Hospital Edgardo Rebagliati Martins de EsSalud y de la Clínica San Felipe, atendidos entre los años 1991 y 2006. En los 63 pacientes evaluados, 86% afirmó haber ingerido cocaína previamente. Los síntomas reportados fueron dolor torácico (59%), palpitaciones (27%), convulsiones (5%), hipertermia (3%) y cefalea (6%). Las entidades clínicas asociadas fueron: síndromes coronarios agudos, arritmia ventricular, infarto agudo de miocardio, crisis hipertensiva y muerte súbita. En conclusión: El empleo de cocaína intranasal se asocia a importantes entidades clínicas cardiovasculares, la mayoría de ellas graves.

Objetivos: Conocer las estrategias de reperfusión en pacientes con síndrome coronario agudo ST elevado (SCASTE) atendidos en el departamento de emergencia de un hospital general, y determinar el tiempo para realizar dichas estrategias a través de los tiempos puerta–aguja (P–A), puerta–balón (P–B), electrocardiograma (ECG) y total de isquemia. Material y métodos: Estudio retrospectivo transversal en pacientes con diagnóstico de SCASTE en el Hospital Nacional Cayetano Heredia (HNCH) desde el 1° de enero de 2011 al 31 de enero de 2013. Se registraron las características demográficas y clínicas, tiempos de reperfusión miocárdica, de síntomas, para toma de ECG. Los factores asociados fueron analizados por análisis bivariado. Resultados: Cuarenta y cinco pacientes fueron elegibles. La edad media fue 60,5 ± 10,98 años, 88,8% fueron varones. El tiempo medio de hospitaliza...