medigraphic.com
SPANISH

Revista de Sanidad Militar

ISSN 0301-696X (Print)
Órgano de difusión del Servicio de Sanidad Militar y del Colegio Nacional de Médicos Militares
  • Contents
  • View Archive
  • Information
    • General Information        
    • Directory
  • Publish
    • Instructions for authors        
  • medigraphic.com
    • Home
    • Journals index            
    • Register / Login
  • Mi perfil

2017, Number 6

<< Back Next >>

Rev Sanid Milit Mex 2017; 71 (6)

Syncope... one more case. Arrhythmogenic cardiomyopathy of the right ventricle

Álvarez GL, Hernández JL, Rosendo GR
Full text How to cite this article

Language: Spanish
References: 16
Page: 565-571
PDF size: 361.30 Kb.


Key words:

Syncope, arrhythmogenic myocardiopathy, sudden death.

ABSTRACT

Introduction: Syncope is defined as a transitory alteration of the consciousness with spontaneous recovery due to an alteration in general cerebral perfusion and is a very common medical condition in the primary care centers and Emergency. It could be the first manifestation of a cardiac condition (6-30% prevalence), being considered in this situation a bad prognosis marker and high-risk marker of sudden death. Clinical case: Male, 25 years old in the emergency because of syncope. He has had these events three times in the last four months. The patient denies chronic-degenerative diseases and resting EKG shows alteration in repolarization in right precordial electrodes. Discussion: Syncope is a high-prevalence clinical manifestation in the primary care medical centers and ER, the meticulous medical approach in each of the events as the first paraclinical studies are directed toward a cardiac condition as the first differential diagnosis, considering primary electro conduction alteration such as myocardiopathy vs alteration in ion transporting channels which have a genetic origin and have a high risk of sudden death. Conclusions: When following the protocol of one more case of syncope in the ER service, clinical and paraclinical studies conclude a definitive diagnosis of arrhythmogenic myocardiopathy in the right ventricle, showing two mayor and two minor principles of genotypification with a report of plakophilin 2 polymorphism.


REFERENCES

  1. Brignole M, Hamdan MH. New concepts in the assessment of syncope. J Am Coll Cardiol. 2012; 59 (18): 1583-1591.

  2. Kapoor WN. Syncope. N Engl J Med. 2000; 343 (25): 1856-1862.

  3. Hanna EB. Syncope: etiology and diagnostic approach. Cleve Clin J Med. 2014; 81 (12): 755-766.

  4. Alboni P, Brignole M, Menozzi C, Raviele A, Del Rosso A, Dinelli M et al. Diagnostic value of history in patients with syncope with or without heart disease. J Am Coll Cardiol. 2001; 37 (7): 1921-1928.

  5. Colivicchi F, Ammirati F, Melina D, Guido V, Imperoli G, Santini M; OESIL (Osservatorio Epidemiologico sulla Sincope nel Lazio) Study Investigators. Development and prospective validation of a risk stratification system for patients with syncope in the emergency department: the OESIL risk score. Eur Heart J. 2003; 24 (9): 811-819.

  6. Francisco JL, Bodegas AI, Gomez C, Arana JI, Barrenetxea JI. R Miocardiopatía arritmogénica de ventrículo derecho. Gac Med Bilbao. 2007; 104: 70-74.

  7. Priori SG, Blomström-Lundqvist C, Mazzanti A, Blom N, Borggrefe M, Camm J et al. Guía ESC 2015 sobre el tratamiento de pacientes con arritmias ventriculares y prevención de la muerte súbita cardiaca. Rev Esp Cardiol. 2016; 69 (2): 176.e1-176.e77.

  8. Corrado D, Link MS, Calkins H. Arrhythmogenic right ventricular cardiomyopathy. N Engl J Med. 2017; 376 (1): 61-72.

  9. Thiene G, Nava A, Corrado D, Rossi L, Pennelli N. Right ventricular cardiomyopathy and sudden death in young people. N Engl J Med. 1988; 318 (3): 129-133.

  10. Reglamento de la Ley General de Salud en materia de control sanitario de la disposición de órganos, tejidos y cadáveres humanos. Capítulo IV de disposición de cadáveres del artículo 60-63.

  11. Palomo Rando JL, Ramos-Medina V, Cruz-Mera E, López-Calvo AM. Diagnóstico del origen y la causa de la muerte después de la autopsia médico-legal (Parte I). Cuad Med Forense. 2010; 16 (4): 217-229.

  12. Nasir K, Bomma C, Tandri H, Roguin A, Dalal D, Prakasa K et al. Electrocardiographic features of arrhythmogenic right ventricular dysplasia/cardiomyopathy according to disease severity: a need to broaden diagnostic criteria. Circulation. 2004; 110 (12): 1527-1534.

  13. Peters S, Trümmel M, Meyners W. Prevalence of right ventricular dysplasia-cardiomyopathy in a non-referral hospital. Int J Cardiol. 2004; 97 (3): 499-501.

  14. Pilichou K, Nava A, Basso C, Beffagna G, Bauce B, Lorenzon A et al. Mutations in desmoglein-2 gene are associated with arrhythmogenic right ventricular cardiomyopathy. Circulation. 2006; 113 (9): 1171-1179.

  15. Priori SG, Blomström-Lundqvist C, Mazzanti A, Blom N, Borggrefe M, Camm J et al. 2015 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: The Task Force for the Management of Patients with Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death of the European Society of Cardiology (ESC) Endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC). Europace. 2015; 17 (11): 1601-1687.

  16. Task Force for the Diagnosis and Management of Syncope; European Society of Cardiology (ESC); European Heart Rhythm Association (EHRA); Heart Failure Association (HFA); Heart Rhythm Society (HRS), Moya A et al. Guidelines for the diagnosis and management of syncope (version 2009). Eur Heart J. 2009; 30 (21): 2631-2671.




2020     |     www.medigraphic.com

Mi perfil

C?MO CITAR (Vancouver)

Rev Sanid Milit Mex. 2017;71