Browsing by Author "Dauvergne, Christian"

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    Infarto agudo de miocardio sin enfermedad coronaria ateroesclerótica obstructiva: utilidad de las imágenes intravasculares y resonancia cardíaca en su diagnóstico
    (2020) Cataldo V., Pabla; Verdugo, Fernando J.; Dauvergne, Christian; García, Alfonso; Antileo, Pablo; Monsalve, Rodrigo; Pineda, Fernando; Méndez, Manuel; Uriarte, Polentzi; Araya H., Mario; Llerena, Pedro; Nauhm, Yalile; Pereira, Gonzalo; Ramos, Cristóbal; Coello V., Marco; Garrido G., Christian; Delgado A., Tomas; González, Soledad; Sandoval B., Jorge
    Background:Myocardial infarction with non-obstructive coronary artery disease (MINOCA) is common. Cardiac magnetic resonance (CMR) and intravascular imaging (IVI) may be useful for establishing its etiology. Aim: To describe a population with MINOCA and its multi-image assessment using IVI or CMR. Material and Methods: Review of medical records, imaging and functional studies of patients with MINOCA treated in three different clinical centers between 2015 and 2019. Results: Twenty-eight patients with MINOCA and IVI were included. Seventy eight percent were women, 46% had hypertension, 32% smoked and 32% had dyslipidemia. At wall motion assessment, 46% presented apical ballooning pattern. In 36% of patients IVI identified lesions that explained the cause of MINOCA, namely plaque disruption (PD) in 18%, spontaneous coronary dissection in 11% and a thrombus without PD in 7%. Forty-six percent of patients had uncomplicated atherosclerotic plaques, and 36% had no pathological findings. CMR was performed in 50% of patients, identifying in all a diagnostic pattern. In nine cases it was compatible with stress cardiomyopathy, three cases had a myocarditis and two cases had transmural infarctions. PD and transmural late gadolinium enhancement were observed in 23% of patients with apical ballooning. Patients with a pattern of myocarditis did not have acute pathological findings at IVI. After a mean follow-up of 16.4±11.4 months, 3 patients with PD died. Conclusions: Among patients with MINOCA, there was a predominance of female gender with low cardiovascular risk factor load. The multi-image assessment allowed greater precision for etiological diagnosis of MINOCA. Apical ballooning was not pathognomonic for stress cardiomyopathy. PD was associated with mortality.
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    Sincope de alto riesgo en paciente joven: Una causa poco frecuente
    (2024) Araya, Francisca Isabel; Dauvergne, Christian; Larrondo, Francisco Javier
    El síncope es una consulta frecuente. Corresponde al 1 a 3% de las atenciones en Servicios de Urgencia en Estados Unidos. La causa es generalmente benigna, sin embargo, los casos de alto riesgo tienen potencial riesgo vital y deben ser identificados. En este manuscrito reportamos un caso de una paciente de 40 años presentándose con síncope que evoluciona con Torsada de puntas y luego fibrilación ventricular. La coronariografía no mostró lesiones coronarias. La ventriculografía, ecocardiografía transtorácica y la resonancia cardíaca fueron compatibles con la cardiomiopatía de Takotsubo medio ventricular. Al ECG destacaba QTc largo con la onda T invertida. Durante las primeras 48 horas presentó múltiples episodios de taquicardia ventricular polimorfa no sostenida. La paciente evolucionó con disminución del QTc y regresión de las alteraciones segmentarias. Al seguimiento a seis meses, la paciente se encontraba asintomática, sin nuevos episodios.

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