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      Síndrome antifosfolipídico y afectación cardiovascular Translated title: Síndrome do anticorpo antifosfolipídeo e comprometimento cardiovascular Translated title: Antiphospholipid syndrome and cardiovascular affectation

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          Abstract

          El síndrome antifosfolípido se define como la presencia de trombosis arteriales o venosas recurrentes, pérdidas repetidas de embarazo y trombocitopenia en presencia de anticuerpos a cardiolipina o anticoagulante lúpico. Se realizo esta revisión con el fin de determinar si este síndrome debe ser considerado actualmente un factor de riesgo cardiovascular. Se presenta en mujeres jóvenes por lo cual al ser diagnosticado nos obliga a realizar un control exhaustivo y debe tener un abordaje multidisciplinario. Dentro de las manifestaciones cardiovasculares el paciente puede presentar infarto agudo de miocardio, endocarditis pseudo-infecciosa, afectación valvular e hipertensión pulmonar.

          Translated abstract

          A síndrome do anticorpo antifosfolipídeo é definida como a presença de trombose arterial ou venosa recorrente, repetidos abortos e trombocitopenia na presença de anticorpos anti-cardiolipina ou lúpus anticoagulante. Esta avaliação foi realizada, a fim de determinar se esta síndrome deve agora ser considerada um fator de risco cardiovascular. Ela ocorre em mulheres jovens, por isso, de ser diagnosticada nos obriga a fazer um estudo aprofundado e deve ter uma abordagem multidisciplinar. Entre as manifestações cardiovasculares, o paciente pode desenvolver infarto agudo do miocárdio, endocardite pseudo-infecciosa, valvopatia e hipertensão pulmonar.

          Translated abstract

          Antiphospholipid syndrome is defined as the presence of recurrent arterial or venous thrombosis, repeated pregnancy loss and thrombocytopenia in the presence of antibodies to cardiolipin or lupus anticoagulant. This review was performed in order to determine whether this syndrome should now be considered a cardiovascular risk factor. It occurs in young women, therefore, to be diagnosed forces us to make a thorough control and should have a multidisciplinary approach. Among the cardiovascular manifestations the patient may develop acute myocardial infarction, pseudo-infectious endocarditis, valve disease and pulmonary hypertension.

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          Most cited references81

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          International consensus statement on preliminary classification criteria for definite antiphospholipid syndrome: report of an international workshop.

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            Thrombosis, abortion, cerebral disease, and the lupus anticoagulant.

            G. Hughes (1983)
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              The heart in systemic lupus erythematosus and the changes induced in it by corticosteroid therapy. A study of 36 necropsy patients.

              The natural history of the cardiovascular manifestations of systemic lupus erythematosus (SLE) have been altered by corticosteroids which exert their own cardiovascular effects. This study describes clinical and necropsy observations in 36 corticosteroid-treated patients with SLE and compares them to necropsy observations in patients with SLE reported before the use of corticosteroid therapy. The 36 patients averaged 32 years of age, and 33 were women. Systemic hypertension was present in 25 (69 per cent) and left ventricular hypertrophy in 23 (64 per cent) patients. Hypertension was twice as common in the 19 patients who received this drug for more than 12 months (average 38 months) than in the 17 patients who received this drug for less than 12 months (average 6 months), and was almost five times more common among our patients than in patients with SLE in the presteroid era. Congestive cardiac failure occurred in 15 patients (43 per cent), eight times more frequent than that reported in noncorticosteroid-treated patients with SLE. Subepicardial and myocardial fat was increased in all 36 patients. Lupus carditis was similar in frequency but differed morphologically in our patients compared to those not treated with corticosteroids. Libman-Sacks-type endocardial lesions, present in 18 (50 per cent) of our patients, were smaller, fewer in number, univalvular rather than multivalvular, and mainly left-sided. Most verrucae were either partly or completely healed, and some were calcified. Pericarditis, present in 19 (53 per cent) patients, was predominantly of the fibrous type. Myocarditis was present in three patients, each of whom also had endocarditis and pericarditis. The lumen of at least one of the three major coronary arteries was narrowed more than 50 per cent by atherosclerotic plaques in 42 per cent of the 18 patients who received corticosteroids for more than 1 year, but in none of the 17 patients who received corticosteroids for less than 1 year. Four of the eight patients with narrowed coronary arteries had myocardial infarcts. Although vital to the management of SLE, corticosteroids have an over-all deleterious effect on the heart. Systemic hypertension and left ventricular hypertrophy appear or, when present, worsen; congestive cardiac failure increases; epicardial apartment of Me
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                Author and article information

                Journal
                ic
                Insuficiencia cardíaca
                Insuf. card.
                Comité Insuficiencia Cardíaca (Ciudad Autónoma de Buenos Aires, , Argentina )
                1852-3862
                June 2014
                : 9
                : 2
                : 66-76
                Affiliations
                [01] Resistencia Chaco orgnameHospital Julio C. Perrando orgdiv1Servicio de Cardiología República Argentina
                Article
                S1852-38622014000200004 S1852-3862(14)00900200004
                fd1d9ed3-ea78-4d17-ac21-aa640dd6f4c9

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 10 February 2014
                : 16 September 2013
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 83, Pages: 11
                Product

                SciELO Argentina


                Síndrome do anticorpo antifosfolipídeo,Anticorpo antifosfolipídeo,Comprometimento cardiovascular,Hipertensão pulmonar,Antiphospholipidic syndrome,Antiphospholipid antibodies,Cardiovascular affectation,Pulmonary hypetension,Síndrome antifosfolipídico,Anticuerpos antifosfolípidos,Afectación cardiovascular,Hipertensión pulmonar

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