Complicaciones mecánicas posinfarto de miocardio en un hospital de referencia nacional

Daniel Espinoza Alva; Milagros Yanina  Mallma Gómez; Juan Manuel Muñoz Moreno

doi:10.47487/apcyccv.v3i1.200

Autores/as

Daniel Espinoza Alva Instituto Nacional Cardiovascular INCOR. Lima, Perú. https://orcid.org/0000-0002-4700-8929
Milagros Yanina Mallma Gómez Instituto Nacional Cardiovascular INCOR. Lima, Perú. https://orcid.org/0000-0002-4520-1717
Juan Manuel Muñoz Moreno Hospital Nacional Edgardo Rebagliati Martins. Lima, Perú. https://orcid.org/0000-0002-2838-1496

DOI:

https://doi.org/10.47487/apcyccv.v3i1.200

Palabras clave:

Infarto del Miocardio, Rotura Cardiaca Posinfarto, Rotura Septal Ventricular

Resumen

Objetivo. Determinar las características clínicas, terapéuticas y la mortalidad intrahospitalaria de los pacientes con complicaciones mecánicas posinfarto de miocardio (IM). Materiales y métodos. Estudio observacional, descriptivo y retrospectivo. Se incluyó a pacientes > 18 años con diagnóstico de complicación mecánica pos-IM hospitalizados en el Instituto Nacional Cardiovascular (INCOR) en Lima-Perú, del 1 de enero de 2017 hasta el 31 de diciembre de 2021. Se estudiaron variables clínicas, terapéuticas, complicaciones y mortalidad intrahospitalaria. Resultados. Se registraron 37 casos, con predominio del sexo masculino (73,0%) y mediana de edad 73 años. La localización del infarto fue en la pared anterior (51,4%) y en la pared inferior (43,2%). Los pacientes recibieron fibrinólisis en cinco casos (13,5%); angioplastia coronaria en cinco casos (13,5%), y el 73% recibieron solo manejo médico previo al diagnóstico de complicación mecánica. De los 37 pacientes, 13 (35,1%) presentaron rupturas de la pared libre ventricular aislada; 12 (32,4%) ruptura de septo interventricular aislada; 10 (27,0%) la combinación ruptura de pared libre ventricular y septo interventricular, y 2 (5,4%) ruptura de músculo papilar. La mortalidad intrahospitalaria fue del 51,4%. Conclusiones. La ruptura de la pared libre ventricular fue la complicación más frecuente; los pacientes con complicaciones mecánicas posinfarto de miocardio presentan tasas de mortalidad intrahospitalaria elevadas, principalmente en aquellos que no reciben tratamiento quirúrgico adecuado.

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Referencias

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