Faculdade de Medicina - FAMED/ICS
URI Permanente desta comunidadehttps://repositorio.ufpa.br/handle/2011/2424
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Item Acesso aberto (Open Access) Anatomopathological aspects of acute Chagas myocarditis by oral transmission(Sociedade Brasileira de Cardiologia, 2016-07) SOUZA, Dilma do Socorro Moraes de; ARAUJO, Marialva Tereza Ferreira de; SANTOS, Paulo Roberto Silva Garcez dos; FURTADO JUNIOR, Julio Cesar Branco; FIGUEIREDO, Maria Tereza Sanches; PÓVOA, Rui Manuel dos SantosVector transmission of Trypanosoma cruzi has declined in Latinpt_B America, which has been attributed to better epidemiological control of this form of transmission, estimated at 8 to 10 million chronic cases, in addition to reducing the number of new cases.1,2 However, there has been an increase in the incidence of acute cases, predominantly by oral transmission due to the ingestion of food contaminated with feces of triatomids, both in isolated cases and in family micro-outbreaks.3 Necropsy studies that describe myocarditis in the acute phase of Chagas' disease are scarce and the existing reports in the literature are of studies carried out in the past decades and involve vector transmission in endemic areas. Cardiac involvement in the acute phase may have varied aspects, especially in relation to myocardial lesion, from an undetectable one, to the evolution to acute heart failure with severe myocarditis and death. Cardiac involvement is present in 90% of the cases, manifesting with myocarditis and pericardial effusion.4,5 The analysis of a series of acute myocarditis cases showed a mortality of 5.6%.Item Acesso aberto (Open Access) Electrocardiogram Performance in the Diagnosis of Left Ventricular Hypertrophy in Hypertensive Patients With Left Bundle Branch Block(Universidade Federal do Pará, 2016-12) BURGOS, Paula Freitas Martins; LUNA FILHO, Bráulio; COSTA, Francisco de Assis; BOMBIG, Maria Teresa Nogueira; SOUZA, Dilma do Socorro Moraes de; BIANCO, Henrique Tria; OLIVEIRA FILHO, Japy Angelini; IZAR, Maria Cristina de Oliveira; FONSECA, Francisco Antonio Helfenstein; PÓVOA, Rui Manuel dos SantosBackground: Left ventricular hypertrophy (LVH) is an important risk factor for cardiovascular events, and its detection usually begins with an electrocardiogram (ECG). Objective: To evaluate the impact of complete left bundle branch block (CLBBB) in hypertensive patients in the diagnostic performance of LVH by ECG. Methods: A total of 2,240 hypertensive patients were studied. All of them were submitted to an ECG and an echocardiogram (ECHO). We evaluated the most frequently used electrocardiographic criteria for LVH diagnosis: Cornell voltage, Cornell voltage product, Sokolow-Lyon voltage, Sokolow-Lyon product, RaVL, RaVL+SV3, RV6 /RV5 ratio, strain pattern, left atrial enlargement, and QT interval. LVH identification pattern was the left ventricular mass index (LVMI) obtained by ECHO in all participants. Results: Mean age was 11.3 years ± 58.7 years, 684 (30.5%) were male and 1,556 (69.5%) were female. In patients without CLBBB, ECG sensitivity to the presence of LVH varied between 7.6 and 40.9%, and specificity varied between 70.2% and 99.2%. In participants with CLBBB, sensitivity to LVH varied between 11.9 and 95.2%, and specificity between 6.6 and 96.6%. Among the criteria with the best performance for LVH with CLBBB, Sokolow-Lyon, for a voltage of≥ 3,0mV, stood out with a sensitivity of 22.2% (CI 95% 15.8 – 30.8) and specificity of 88.3% (CI 95% 77.8 – 94.2). Conclusion: In hypertensive patients with CLBBB, the most often used criteria for the detection of LVH with ECG showed significant decrease in performance with regards to sensitivity and specificity. In this scenario, Sokolow-Lyon criteria with voltage ≥3,0mV presented the best performance. (Arq Bras Cardiol. 2017; 108(1):47-52).