EL CORAZÓN EN LA ESCLEROSIS SISTÉMICA

Presentación del tema: "EL CORAZÓN EN LA ESCLEROSIS SISTÉMICA"— Transcripción de la presentación:

1 EL CORAZÓN EN LA ESCLEROSIS SISTÉMICA
JOSÉ LUIS CALLEJAS UNIDAD DE ENF, SISTÉMICAS H. NUEVO SAN CECILIO, GRANADA

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3 Myocardial involvement
Atherosclerosis Arrhythmias and conduction defects Pericardial involvement SSc-related endocarditis

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8 DARTH CORTICOIDE

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10 LA ES, EL DERRAME PERICÁRDICO Y LA TOMA DE CORTIS

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17 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

18 DISFUNCIÓN SISTÓLICA V.I

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22 ANTE LA DUDA…

23 - 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. *

24 DI SFUNCIÓN DI ASTÓLICA

25 LA DISFUNCIÓN VENTRICULAR ES CAUSA DE DISNEA

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34 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.

35 HACER POR HACER

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37 -CMR was performed early after diagnosis in 78 treatment-naïve CTDs

38 CMR was performed early after diagnosis in 78 treatment-naïve CTDs

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41 - 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

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43 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%)

44 PROPUESTA ESTUDIO PARA AADEA.
HACER POR HACER POS HABRÁ QUE HACER. PROPUESTA ESTUDIO PARA AADEA.

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