{"id":165,"date":"2024-01-31T16:16:10","date_gmt":"2024-01-31T22:16:10","guid":{"rendered":"https:\/\/drmerinocardiologo.com\/?p=165"},"modified":"2024-02-12T17:25:43","modified_gmt":"2024-02-12T23:25:43","slug":"la-vejez-duele","status":"publish","type":"post","link":"https:\/\/drmerinocardiologo.com\/index.php\/2024\/01\/31\/la-vejez-duele\/","title":{"rendered":"Caso real: Enfermedad de multivaso\u200b"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-post\" data-elementor-id=\"165\" class=\"elementor elementor-165\">\n\t\t\t\t<div class=\"elementor-element elementor-element-4391837 e-flex e-con-boxed e-con e-parent\" data-id=\"4391837\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div class=\"elementor-element elementor-element-9c47725 e-con-full e-flex e-con e-child\" data-id=\"9c47725\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-ca8cac2 e-con-full e-flex e-con e-child\" data-id=\"ca8cac2\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-7e973db elementor-widget elementor-widget-heading\" data-id=\"7e973db\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Caso real: Enfermedad de multivaso<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-d4b4b95 elementor-widget elementor-widget-text-editor\" data-id=\"d4b4b95\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<div class=\"xdj266r x11i5rnm xat24cr x1mh8g0r x1vvkbs x126k92a\"><div dir=\"auto\">La primera publicaci\u00f3n de este a\u00f1o. Iniciamos con un caso interesante.<\/div><\/div><div class=\"x11i5rnm xat24cr x1mh8g0r x1vvkbs xtlvy1s x126k92a\"><div dir=\"auto\">Para protecci\u00f3n de la privacidad del paciente vamos a obviar el nombre.<\/div><\/div><div class=\"x11i5rnm xat24cr x1mh8g0r x1vvkbs xtlvy1s x126k92a\"><div dir=\"auto\">Vino a mi consulta desde Estados Unidos en los \u00faltimos d\u00edas del mes de diciembre. Para esas fechas vienen muchos salvadore\u00f1os residentes en ese pa\u00eds. Su principal s\u00edntoma era una opresi\u00f3n en el pecho, inc\u00f3moda, un malestar que no llegaba a ser dolor, pero que aparec\u00eda cuando caminaba, y que le obligaba a detenerse. Se esperaba unos minutos mientras bajaba el malestar, y luego continuaba. Ese s\u00edntoma lo obligaba a detenerse varias veces hasta llegar a su destino.<\/div><div dir=\"auto\">\u00a0<\/div><\/div><div class=\"x11i5rnm xat24cr x1mh8g0r x1vvkbs xtlvy1s x126k92a\"><div dir=\"auto\">Al examinarlo f\u00edsicamente, todo estaba normal, su presi\u00f3n arterial, su frecuencia cardiaca, hasta el electrocardiograma y el ecocardiograma estaban normales. Sin embargo, la prueba de esfuerzo estaba positiva. Esta prueba consiste en reproducir el esfuerzo del paciente al caminar, y detectar falta de ox\u00edgeno al coraz\u00f3n (isquemia) durante este periodo. Abajo les muestro im\u00e1genes con fines educativos.<\/div><div dir=\"auto\">\u00a0<\/div><\/div><div class=\"x11i5rnm xat24cr x1mh8g0r x1vvkbs xtlvy1s x126k92a\"><div dir=\"auto\">S\u00faper curioso el hecho de encontrar el examen f\u00edsico normal, y los ex\u00e1menes iniciales (electrocardiograma y ecocardiograma) sin alteraciones. Y lo m\u00e1s interesante, el paciente nunca fum\u00f3, realizaba ejercicio regularmente, mediana-edad (52 a\u00f1os), sin obesidad, pero solo un detalle en contra: Se desvelaba mucho en su trabajo. Y en ese sentido se sabe que la privaci\u00f3n cr\u00f3nica del sue\u00f1o puede aumentar la inflamaci\u00f3n en el cuerpo, puede afectar el metabolismo, y alterar el ritmo circadiano del coraz\u00f3n. El riesgo de la privaci\u00f3n cr\u00f3nica del sue\u00f1o es tan peligrosa para el coraz\u00f3n como lo es el estr\u00e9s cr\u00f3nico, la inactividad f\u00edsica, y la mala alimentaci\u00f3n.\u00a0<span style=\"color: var( --e-global-color-text ); font-family: var( --e-global-typography-text-font-family ), Sans-serif; font-weight: var( --e-global-typography-text-font-weight ); text-align: var(--text-align); background-color: var(--ast-global-color-5); font-size: 1rem;\">La investigaci\u00f3n: \u201cAsociaci\u00f3n de la duraci\u00f3n y la calidad del sue\u00f1o con la aterosclerosis subcl\u00ednica\u201d publicado en el Journal of the American College of Cardiology en el 2016, examin\u00f3 la relaci\u00f3n entre la duraci\u00f3n y la calidad del sue\u00f1o con la presencia de aterosclerosis subcl\u00ednica, un marcador temprano de enfermedad cardiaca.<\/span><\/div><\/div><div class=\"x11i5rnm xat24cr x1mh8g0r x1vvkbs xtlvy1s x126k92a\"><div dir=\"auto\">\u00a0<\/div><\/div><div class=\"x11i5rnm xat24cr x1mh8g0r x1vvkbs xtlvy1s x126k92a\"><div dir=\"auto\">Otro estudio relevante: &#8220;El sue\u00f1o cr\u00f3nico insuficiente y el caos del ritmo circadiano se asocian con el riesgo de enfermedad cardiovascular\u201d, publicado en the Journal of Cardiology en 2019, explor\u00f3 la asociaci\u00f3n entre la falta cr\u00f3nica de sue\u00f1o y el caos en el ritmo circadiano con el riesgo de enfermedades cardiovasculares.<\/div><div dir=\"auto\">\u00a0<\/div><\/div><div class=\"x11i5rnm xat24cr x1mh8g0r x1vvkbs xtlvy1s x126k92a\"><div dir=\"auto\">Ya para finalizar, le realic\u00e9 un Angio-Tac coronario (un estudio que combina tomograf\u00eda con administraci\u00f3n de yodo endovenoso) debido a detalles que se presentaron en la prueba de esfuerzo donde sospech\u00e9 enfermedad multivaso, y efectivamente, aquel malestar que parec\u00eda insignificante para el paciente, terminar\u00eda siendo un aviso de una enfermedad coronaria grave con implicaciones quir\u00fargicas.<\/div><div dir=\"auto\">\u00a0<\/div><\/div><div class=\"x11i5rnm xat24cr x1mh8g0r x1vvkbs xtlvy1s x126k92a\"><div dir=\"auto\">Cuando ya sab\u00eda exactamente qu\u00e9 ten\u00eda, no me qued\u00f3 m\u00e1s que felicitarlo por haber enfrentado el miedo al diagn\u00f3stico. Muchos pacientes, mayoritariamente hombres, tienen temor a un diagn\u00f3stico que no les favorezca. Enfrentar esta barrera mental, puede prolongar la vida de muchos pacientes.<\/div><div dir=\"auto\">\u00a0<\/div><\/div><div class=\"x11i5rnm xat24cr x1mh8g0r x1vvkbs xtlvy1s x126k92a\"><div dir=\"auto\">Recomendaciones:<\/div><\/div><div class=\"x11i5rnm xat24cr x1mh8g0r x1vvkbs xtlvy1s x126k92a\"><div dir=\"auto\">1. Duerma lo estipulado. 6 a 8 horas es lo recomendado.<\/div><\/div><div class=\"x11i5rnm xat24cr x1mh8g0r x1vvkbs xtlvy1s x126k92a\"><div dir=\"auto\">2. Ante s\u00edntomas inexplicables, busque ayuda profesional. No vaya por las ramas, vaya al especialista en el problema que tiene.<\/div><\/div><div class=\"x11i5rnm xat24cr x1mh8g0r x1vvkbs xtlvy1s x126k92a\"><div dir=\"auto\">3. Intente mejorar su calidad de vida para este 2024.<\/div><\/div>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-23f1018 elementor-widget elementor-widget-image\" data-id=\"23f1018\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img fetchpriority=\"high\" decoding=\"async\" width=\"1024\" height=\"1024\" src=\"https:\/\/drmerinocardiologo.com\/wp-content\/uploads\/2024\/01\/416121952_917549697037446_4811229595704792385_n-1024x1024.jpg\" class=\"attachment-large size-large wp-image-444\" alt=\"\" srcset=\"https:\/\/drmerinocardiologo.com\/wp-content\/uploads\/2024\/01\/416121952_917549697037446_4811229595704792385_n-1024x1024.jpg 1024w, https:\/\/drmerinocardiologo.com\/wp-content\/uploads\/2024\/01\/416121952_917549697037446_4811229595704792385_n-300x300.jpg 300w, https:\/\/drmerinocardiologo.com\/wp-content\/uploads\/2024\/01\/416121952_917549697037446_4811229595704792385_n-150x150.jpg 150w, https:\/\/drmerinocardiologo.com\/wp-content\/uploads\/2024\/01\/416121952_917549697037446_4811229595704792385_n-768x768.jpg 768w, https:\/\/drmerinocardiologo.com\/wp-content\/uploads\/2024\/01\/416121952_917549697037446_4811229595704792385_n.jpg 1080w\" sizes=\"(max-width: 1024px) 100vw, 1024px\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Para esas fechas vienen muchos salvadore\u00f1os residentes en ese pa\u00eds. Su principal s\u00edntoma era una opresi\u00f3n en el pecho, inc\u00f3moda, un malestar que no llegaba a ser dolor, pero que aparec\u00eda cuando caminaba, y que le obligaba a detenerse.<\/p>\n","protected":false},"author":1,"featured_media":589,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-gradient":""}},"footnotes":""},"categories":[1],"tags":[],"class_list":["post-165","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-blog"],"rttpg_featured_image_url":{"full":["https:\/\/drmerinocardiologo.com\/wp-content\/uploads\/2024\/01\/Pruebas-3.png",900,1200,false],"landscape":["https:\/\/drmerinocardiologo.com\/wp-content\/uploads\/2024\/01\/Pruebas-3.png",900,1200,false],"portraits":["https:\/\/drmerinocardiologo.com\/wp-content\/uploads\/2024\/01\/Pruebas-3.png",900,1200,false],"thumbnail":["https:\/\/drmerinocardiologo.com\/wp-content\/uploads\/2024\/01\/Pruebas-3.png",72,96,false],"medium":["https:\/\/drmerinocardiologo.com\/wp-content\/uploads\/2024\/01\/Pruebas-3.png",900,1200,false],"large":["https:\/\/drmerinocardiologo.com\/wp-content\/uploads\/2024\/01\/Pruebas-3.png",900,1200,false],"1536x1536":["https:\/\/drmerinocardiologo.com\/wp-content\/uploads\/2024\/01\/Pruebas-3.png",900,1200,false],"2048x2048":["https:\/\/drmerinocardiologo.com\/wp-content\/uploads\/2024\/01\/Pruebas-3.png",900,1200,false]},"rttpg_author":{"display_name":"Dr. Merino","author_link":"https:\/\/drmerinocardiologo.com\/index.php\/author\/walter-navarreteh2\/"},"rttpg_comment":0,"rttpg_category":"<a href=\"https:\/\/drmerinocardiologo.com\/index.php\/category\/blog\/\" rel=\"category tag\">Blog<\/a>","rttpg_excerpt":"Para esas fechas vienen muchos salvadore\u00f1os residentes en ese pa\u00eds. Su principal s\u00edntoma era una opresi\u00f3n en el pecho, inc\u00f3moda, un malestar que no llegaba a ser dolor, pero que aparec\u00eda cuando caminaba, y que le obligaba a detenerse.","_links":{"self":[{"href":"https:\/\/drmerinocardiologo.com\/index.php\/wp-json\/wp\/v2\/posts\/165"}],"collection":[{"href":"https:\/\/drmerinocardiologo.com\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/drmerinocardiologo.com\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/drmerinocardiologo.com\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/drmerinocardiologo.com\/index.php\/wp-json\/wp\/v2\/comments?post=165"}],"version-history":[{"count":30,"href":"https:\/\/drmerinocardiologo.com\/index.php\/wp-json\/wp\/v2\/posts\/165\/revisions"}],"predecessor-version":[{"id":592,"href":"https:\/\/drmerinocardiologo.com\/index.php\/wp-json\/wp\/v2\/posts\/165\/revisions\/592"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/drmerinocardiologo.com\/index.php\/wp-json\/wp\/v2\/media\/589"}],"wp:attachment":[{"href":"https:\/\/drmerinocardiologo.com\/index.php\/wp-json\/wp\/v2\/media?parent=165"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/drmerinocardiologo.com\/index.php\/wp-json\/wp\/v2\/categories?post=165"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/drmerinocardiologo.com\/index.php\/wp-json\/wp\/v2\/tags?post=165"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}