García-Rueda JE, Bermúdez-Flórez AM, Londoño-García R, Saavedra-González YA

Idioma: Inglés [English version]
Referencias bibliográficas: 23
Paginas: 26-31
Archivo PDF: 290.35 Kb.

RESUMEN

La disección coronaria espontánea (DCE) es una causa poco frecuente de infarto agudo de miocardio, principalmente se presenta en personas jóvenes y de edad media sin factores de riesgo cardiovascular. La presentación clínica depende del grado de afectación y puede ir desde dolor torácico en 85-96% de los casos, síndrome coronario agudo con elevación del ST (SCACEST) en 20-50%, arritmias ventriculares en 3-5%, choque cardiogénico en 2%, muerte súbita o taponamiento pericárdico. Existen algunos factores predisponentes como sexo femenino, embarazo, edad < 50 años, tratamiento hormonal, enfermedades del tejido conectivo (síndrome de Ehlers-Danlos vascular, síndrome de Marfan) y displasia fibromuscular. Así mismo, se han identificado algunos factores desencadenantes como el estrés emocional y físico, ejercicio intenso isométrico y levantamiento de pesas. La angiografía coronaria es el método de elección para hacer el diagnóstico y clasificación. Con relación a su tratamiento, se prefiere en la mayoría de los casos un manejo conservador sobre la revascularización en pacientes estables. Se presenta el caso de un paciente con SCACEST y parada cardiaca secundaria a disección coronaria espontánea mientras realizaba actividad física.

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