EL CORAZÓN EN LA ESCLEROSIS SISTÉMICA JOSÉ LUIS CALLEJAS UNIDAD DE ENF, SISTÉMICAS H. NUEVO SAN CECILIO, GRANADA
Myocardial involvement Atherosclerosis Arrhythmias and conduction defects Pericardial involvement SSc-related endocarditis
DARTH CORTICOIDE
LA ES, EL DERRAME PERICÁRDICO Y LA TOMA DE CORTIS
PACIENTE CON ESCLEROSIS SISTÉMICA CON DISNEA ¿ Tendrá una HP?....BNP, DLCO, ecocardio-Doppler reposo/esfuerzo/CCD reposo/CCD esfuerzo ¿Tendrá una insuficiencia cardíaca?...BNP/ecocardiograma
DISFUNCIÓN SISTÓLICA V.I
ANTE LA DUDA…
- moderate dose CS (<15mg/ day)± pulse CYC* If: The working group recommends: - moderate dose CS (<15mg/ day)± pulse CYC* If: a myocarditis or other features of SSc-CM are evident moderatesevere LV dysfunction (not secondary to atherosclerotic heart disease) and life-threatening cardiac arrhythmias. *
DI SFUNCIÓN DI ASTÓLICA
LA DISFUNCIÓN VENTRICULAR ES CAUSA DE DISNEA
v - Patients with postcapillary PH were defined as having a DPG of <7 mm Hg - Combined PH were defined as having a DPG of ≥7 mm Hg However, randomized trials are needed in SSc patients with an elevated PAWP to determine the clinical utility of treatment with PHspecific medications.
HACER POR HACER
-CMR was performed early after diagnosis in 78 treatment-naïve CTDs
CMR was performed early after diagnosis in 78 treatment-naïve CTDs
- 7/62 with dSSc and 2/20 with lSSc, although they had no cardiac symptoms/signs, were positive for myocarditis - In all 9 SSc patients, 3/3 indices were positive for myocarditis Seguir con tropos, BNP y ecocardio Repetir RM a los positivos en 1 año Repetir RM a todos, ya que la miocarditis puede ser, de hecho era, asintomática Irme a Lago Louis una semana, si es posible en buena compañía Poner tratamiento con IS
CMR was performed in 16 consecutive patients with SSc,of recent onset, immediately after the diagnosis. Stress perfusion defects of left ventricle were detected in six out of 16 (37.5%)
PROPUESTA ESTUDIO PARA AADEA. HACER POR HACER POS HABRÁ QUE HACER. PROPUESTA ESTUDIO PARA AADEA.