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2025, Número 03

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Med Int Mex 2025; 41 (03)


Disección coronaria espontánea: diagnóstico y tratamiento. Actualización

Trujillo FD, López BM

Idioma: Español
Referencias bibliográficas: 145
Paginas: 152-168
Archivo PDF: 959.62 Kb.


RESUMEN

Antecedentes: La disección coronaria espontánea es una del las causas del síndrome coronario agudo que ha adquirido un papel relevante en los últimos años. El refinamiento de las técnicas diagnósticas ha permitido esclarecer su fisiopatología y, con ello, la planeación del tratamiento adecuado para evitar futuras complicaciones. Destaca el papel etiológico de múltiples factores que actúan en concierto para culminar en una sinfonía clínica, por lo que el conocimiento preciso permitirá la identificación oportuna de esta población vulnerable.
Objetivo: Proporcionar la información más actualizada de la disección coronaria espontánea que tendrá mayor incidencia ante el progreso y mayor uso de la imagen intravascular coronaria en el campo clínico actual.
Metodología: Revisión semisistemática que incluyó artículos en inglés y español, de tipo ensayos clínicos controlados, estudios de cohorte y observacionales, con fecha de publicación de los últimos 14 años (2009 a 2023). La búsqueda de referencias estuvo limitada a la base de datos PubMed-Medline con la estrategia de búsqueda definida por las palabras clave (MeSH): “Acute coronary syndrome”; “Coronary disease”; “Conservative management”; “Percutaneous coronary intervention”.
Resultados: Se encontraron 643 artículos. En la primera fase del proceso de selección (título y resumen) se conservaron 296 artículos. En la segunda fase (texto completo) se seleccionaron 145 y el resto se rechazaron por no estar directamente relacionados con la disección coronaria ni con el síndrome coronario agudo, artículos duplicados, estudios con metodología débil, o intrascendentes.
Conclusiones: La disección coronaria espontánea es una enfermedad que requiere un alto índice de sospecha clínica a fin de poder implementar los métodos diagnósticos más actuales en el momento preciso y, con ello, otorgar el tratamiento apropiado que, en la mayoría de los casos, es de tipo expectante.


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