Complex coronary lesions represent challenging findings for percutaneous coronary intervention and potentially lead to complications during their approach. We present the case of a patient with decompensated heart failure of ischemic origin who presented multiple complex lesions on coronary angiography. The initial approach to the marginal artery was complicated by a severe coronary perforation that was satisfactorily resolved and in the second moment, a bifurcation lesion of the right coronary artery was successfully treated using the inverted Culotte technique.

Non-valvular Infective endocarditis (IE) is exceedingly rare; however, its incidence has risen in tandem with the increased usage of intracardiac devices and the growing prevalence of risk factors associated with IE. We present a clinical case involving an 18-year-old patient with IE occurring at an atypical location, concomitant with central venous catheter bloodstream infection. The patient underwent targeted antibiotic therapy but ultimately required surgical resection of the vegetation due to multiple risk factors associated with a poor prognosis. This case underscores the importance of maintaining a low threshold of suspicion for IE and emphasizes the need for heightened vigilance regarding non-valvular tissues hosting foreign bodies. These less common locations pose a risk for vegetation development. Additionally, we underscore the pivotal role of 3D echocardiography tools i...

Agenesis or hypoplasia of the posterior leaflet of the mitral valve (HPMVL) is a rare congenital anomaly, and its finding in adulthood is even more extraordinary because of the high morbidity and mortality generated in childhood. Its association with other congenital heart defects has been reported. We present a clinical case of an adult from the Andes with HPMVL associated with a bicuspid aortic valve (BAV)—which generated severe and moderate valvar regurgitation— who underwent successful surgery.

Shaggy aorta (SA) is characterized by a critical and extensive atheromatous disease of the thoracic and abdominal aorta. This degenerative and dangerous pathology is the result of the confluence of multiple modifiable and non-modifiable risk factors. The clinical importance of this pathology relies on the various syndromes that can develop from its etiopathogenesis, which generates great morbidity and mortality in the affected patients. In this document, we present an updated and detailed review of this entity, developing aspects of its pathophysiology, diagnosis, including the importance of multimodal imaging, and its therapeutic approach. Finally, we present the clinical settings of patients with SA in different aortic scenarios (aortic dissection, ulcerated plaques, and thrombosed aneurysms) that denote the nature of this disease and its high mortality.

Non-valvular Infective endocarditis (IE) is exceedingly rare; however, its incidence has risen in tandem with the increased usage of intracardiac devices and the growing prevalence of risk factors associated with IE. We present a clinical case involving an 18-year-old patient with IE occurring at an atypical location, concomitant with central venous catheter bloodstream infection. The patient underwent targeted antibiotic therapy but ultimately required surgical resection of the vegetation due to multiple risk factors associated with a poor prognosis. This case underscores the importance of maintaining a low threshold of suspicion for IE and emphasizes the need for heightened vigilance regarding non-valvular tissues hosting foreign bodies. These less common locations pose a risk for vegetation development. Additionally, we underscore the pivotal role of 3D echocardiography tools in anato...

Complex coronary lesions represent challenging findings for percutaneous coronary intervention and potentially lead to complications during their approach. We present the case of a patient with decompensated heart failure of ischemic origin who presented multiple complex lesions on coronary angiography. The initial approach to the marginal artery was complicated by a severe coronary perforation that was satisfactorily resolved and in the second moment, a bifurcation lesion of the right coronary artery was successfully treated using the inverted Culotte technique.

Shaggy aorta (SA) is characterized by a critical and extensive atheromatous disease of the thoracic and abdominal aorta. This degenerative and dangerous pathology is the result of the confluence of multiple modifiable and non-modifiable risk factors. The clinical importance of this pathology relies on the various syndromes that can develop from its etiopathogenesis, which generates great morbidity and mortality in the affected patients. In this document, we present an updated and detailed review of this entity, developing aspects of its pathophysiology, diagnosis, including the importance of multimodal imaging, and its therapeutic approach. Finally, we present the clinical settings of patients with SA in different aortic scenarios (aortic dissection, ulcerated plaques, and thrombosed aneurysms) that denote the nature of this disease and its high mortality.

Complex coronary lesions represent challenging findings for percutaneous coronary intervention and potentially lead to complications during their approach. We present the case of a patient with decompensated heart failure of ischemic origin who presented multiple complex lesions on coronary angiography. The initial approach to the marginal artery was complicated by a severe coronary perforation that was satisfactorily resolved and in the second moment, a bifurcation lesion of the right coronary artery was successfully treated using the inverted Culotte technique.

Non-valvular Infective endocarditis (IE) is exceedingly rare; however, its incidence has risen in tandem with the increased usage of intracardiac devices and the growing prevalence of risk factors associated with IE. We present a clinical case involving an 18-year-old patient with IE occurring at an atypical location, concomitant with central venous catheter bloodstream infection. The patient underwent targeted antibiotic therapy but ultimately required surgical resection of the vegetation due to multiple risk factors associated with a poor prognosis. This case underscores the importance of maintaining a low threshold of suspicion for IE and emphasizes the need for heightened vigilance regarding non-valvular tissues hosting foreign bodies. These less common locations pose a risk for vegetation development. Additionally, we underscore the pivotal role of 3D echocardiography tools i...

Shaggy aorta (SA) is characterized by a critical and extensive atheromatous disease of the thoracic and abdominal aorta. This degenerative and dangerous pathology is the result of the confluence of multiple modifiable and non-modifiable risk factors. The clinical importance of this pathology relies on the various syndromes that can develop from its etiopathogenesis, which generates great morbidity and mortality in the affected patients. In this document, we present an updated and detailed review of this entity, developing aspects of its pathophysiology, diagnosis, including the importance of multimodal imaging, and its therapeutic approach. Finally, we present the clinical settings of patients with SA in different aortic scenarios (aortic dissection, ulcerated plaques, and thrombosed aneurysms) that denote the nature of this disease and its high mortality.

Introducción: La hipertensión arterial y la depresión, son un problema de salud altamente prevalentes, pudiendo presentarse concomitantemente en un mismo individuo. Analizar si existe alguna relación entre ambas patologías permitiría al clínico abordar al paciente de una manera integral. Objetivo: Determinar la asociación entre hipertensión arterial y síntomas depresivos en pacientes atendidos en consultorio externo de cardiología del Hospital III Goyeneche desde Febrero a Marzo 2019. Materiales y Método: Se realizó un estudio analítico, transversal, de casos y controles. La población estuvo constituida de 168 pacientes. Se les cuantificó la presión arterial, pesó y talló, y se aplicó un cuestionario epidemiológico y el test “PHQ-9”, valorando la asociación entre variables mediante pruebas estadísticas. Resultados: El 61.9% y 39.29% de los hipertensos y normote...

Antecedentes: La reperfusión precoz del miocardio puede prevenir la necrosis. Más allá de esta fase temprana, el número de miocitos recuperados -y, por tanto, la cantidad de tejido miocárdico recuperado (área de necrosis/área en riesgo)- está directamente relacionado con la duración de la oclusión de la arteria coronaria, el nivel de consumo miocárdico de oxígeno y el flujo sanguíneo colateral. Objetivo: Evaluar el impacto de la revascularización percutánea en pacientes con diagnóstico de infarto de miocardio con elevación del segmento ST (IAMCEST) y “late comers” (que se presentaron después de las primeras 12 horas del inicio de los síntomas). Materiales y métodos: Estudio observacional, retrospectivo y analítico, realizado en pacientes mayores de 18 años con diagnóstico de IAMCEST y “late comers”, sometidos a revascularización percutánea en Sala de Hemo...

Catheter ablation is a curative and effective therapeutic option for idiopathic and symptomatic right ventricular outflow tract (RVOT) ventricular tachycardia (VT). However, cases of coronary artery injury during catheter ablation have been reported. 2, 3, 4 Anomalous aortic origin of the coronary artery (AAOCA) is a rare condition, usually associated with an abnormal trajectory of the involved vessels, being a “double-edged sword,” depending on whether the coronary artery is distant or close to the site of origin of the VT. Therefore, in these cases it is essential to determine the relationship between these structures to avoid iatrogenic damage to the epicardial vessels. There is only one reported case of successful ablation of RVOT VT in a patient with an anomalous aortic origin of right coronary artery (R-AAOCA), in which the artery ran very close to the ablation site (risk facto...

Aortic stenosis is associated with aortic plaques in up to 85% of cases because they share risk factors and pathogenic pathways. Intrinsically, complex aortic plaques carry a high risk of stroke, which has also been demonstrated in the context of aortic stenosis, especially in patients who underwent percutaneous or surgical replacement. Transesophageal echocardiography (TEE) is the imaging test of choice to detect plaques in the thoracic aorta and classify them as complex plaques. Furthermore, the 3D modality allows us to better specify its dimensions and anatomical characteristics, such as added thrombi or the presence of ulcers inside. This review aims to evaluate the use of TEE to detect complex aortic plaques in patients with an indication for percutaneous or surgical aortic valve replacement. To highlight the association between aortic stenosis and complex aortic plaques, we...

Aortic stenosis is associated with aortic plaques in up to 85% of cases because they share risk factors and pathogenic pathways. Intrinsically, complex aortic plaques carry a high risk of stroke, which has also been demonstrated in the context of aortic stenosis, especially in patients who underwent percutaneous or surgical replacement. Transesophageal echocardiography (TEE) is the imaging test of choice to detect plaques in the thoracic aorta and classify them as complex plaques. Furthermore, the 3D modality allows us to better specify its dimensions and anatomical characteristics, such as added thrombi or the presence of ulcers inside. This review aims to evaluate the use of TEE to detect complex aortic plaques in patients with an indication for percutaneous or surgical aortic valve replacement. To highlight the association between aortic stenosis and complex aortic plaques, we attache...