Introduction: Former athletes and those who exercise regularly generally have a favorable cardiovascular profile, although they may exhibit masked hypertension or abnormal blood pressure patterns. Ambulatory blood pressure monitoring offers a more accurate assessment than conventional clinical measurements. Objective: To evaluate the effects of physical exercise on blood pressure using ambulatory blood pressure monitoring in former athletes and physical activity practitioners with a history of arterial hypertension. Material and Methods: A cross-sectional and analytical study was carried out from January to December 2023 with 76 former athletes and practitioners of hypertensive exercises. Ambulatory blood pressure was measured by 24-hour monitoring and in office. The effect of risk factors on blood pressure control was evaluated using non-parametric tests and odds ratio. Results: 80.3% of patients had controlled blood pressure. The ambulatory measurement of these values had lower results than those of office. Smoking was the most frequent cardiovascular risk factor with a 27.6% and the only one significantly associated with uncontrolled blood pressure. Conclusions: Ambulatory blood pressure monitoring showed that regular physical exercise significantly contributes to blood pressure control in former athletes and those who engage in physical activity. In this population, the prevalence of cardiovascular risk factors was low.
Pulmonary thromboembolism is defined as the sudden obstruction of the pulmonary circulation by an embolus originating from the venous system, most commonly from the lower extremities or the pelvic region. Its most severe form, high-risk pulmonary thromboembolism, presents with acute right ventricular failure, hypotension, or cardiogenic shock. It is among the top five causes of death worldwide. Immediate reperfusion measures, along with cardiovascular and respiratory life support, are required to prevent rapid hemodynamic deterioration and to improve patient survival. We present the case of a patient who arrived at the emergency department with a clinical presentation of acute right ventricular failure due to high-risk pulmonary thromboembolism, treated with a mechanical-pharmacological approach as an alternative to guideline-recommended therapy, resulting in successful recovery.
Introduction: Ischemic heart disease is the leading cause of death in Cuba and the world, and management of ist risk factors has proven to be effective. Objective: To identify cardiovascular risk factors for ischeamic heart disease in adult patients at the XX Anniversary University Teaching Polyclinic in Santa Clara. Methods: An epidemiological, analytical, and case-control study was carried out between May 2019 and February 2020 at the XX Anniversary University Teaching Polyclinic in the municipality of Santa Clara, Villa Clara. 840 subjects over 50 years of age were selected using probability and two-stage sampling. A multivariate logistic regression analysis was performed to determine the risk factors associated with ischemic heart disease. Results: The most significant risk factors were: positive family history of ischemic heart disease (38.2%), high consumption of animal fats (33.9%), high wais/hip ratio and abdominal circumference (33.8%). Conclusions: In the studied population, the cardiovascular risk factors that showed an independent and significant association with ischemic heart disease were high consumption of animal fats, hypercholesterolemia, diabetes mellitus, low consumption of fish, smoking, and family history of the disease.
Introduction: Acute myocardial infarction is the most severe form of ischemic heart disease and has the highest mortality rate. Objective: To determine the factors associated with mortality from ST-segment elevation myocardial infarction (STEMI) at the emergency department of the Dr. Agostinho Neto General Teaching Hospital. Methods: A descriptive, cross-sectional study was conducted on all patients discharged with a diagnosis of acute myocardial infarction (n=130). A series of variables were analyzed to determine their association with mortality. Results: Mortality was 24.3% in patients over 60 years of age, slightly higher than in those under this age. The incidence of risk factors was high in the sample, especially systemic hypertension, diabetes mellitus, and smoking. A known history of previous ischemic heart disease, although not the most prevalent, was also significantly associated with mortality. Variables related to death in the sample included the presence of intense retrosternal pain, accompanied by palpitations, or the onset of cardiac arrest, especially in patients with anterior topography infarction and in whom reperfusion was not achieved during thrombolysis. Conclusions: Mortality from ST-segment elevation myocardial infarction was associated with some factors such as age, pain intensity, and anterior wall location
We present the case of a 37-year-old woman with Ebstein's anomaly and a prior tricuspid valve replacement. At 38.2 weeks of gestation, she underwent an elective cesarean delivery without complications. We propose a schematic representation of a standardized workflow system for pregnant women with heart disease in obstetric critical care units. Ebstein's anomaly is a rare congenital heart defect, with a prevalence of less than 0.3%, and limited evidence regarding its prognosis during pregnancy. Management requires a multidisciplinary approach, with primary emphasis on controlling heart failure. Implementation of the proposed workflow reduces indirect maternal mortality. Systematizing evidence-based interventions minimizes human error in complex scenarios and transforms empirical management into a protocol-driven strategy that ensures maternal and fetal
