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Alandro Miranda, Iguer Fernando
CorSalud, 2009, Volume: 1, Issue: 3Journal Article
The reduction of mortality due to ischemic heart disease is one of the objectives of the Health Systems in the developed nations, and in Cuba as well. After an acute myocardial infarction, or after a chronic obstruction of a coronary artery, a contractile dysfunction of the cardiac muscle appears. This dysfunction can be partially or totally reversible. With a surgical and percutaneous myocardial revascularization it is possible to restore the flow of blood to the ischemic area; however, these procedures would be in vain if the reperfused muscle is not viable. That is why the tests which assess the myocardial viability are so important and represent an indispensable tool to guarantee the success. During the last years some concepts have been modified, some diagnosis techniques have been developed; and the therapeutics, both medical and surgical, is in a process of evolution. The most useful diagnosis methods to determine myocardial viability are commented in this article. Disminuir la mortalidad por cardiopatía isquémica es uno de los objetivos de los sistemas de salud en los países desarrollados y también de Cuba. Después de un infarto agudo del miocardio o tras la oclusión crónica de una arteria coronaria aparece disfunción contráctil del músculo cardíaco que puede ser parcial o totalmente reversible. Con la revascularización miocárdica percutánea y quirúrgica se logra restablecer el flujo sanguíneo a la zona isquémica; sin embargo, estos procedimientos carecerían de valor si el músculo reperfundido no fuera viable. Por eso cobran tanto valor las pruebas que evalúan la viabilidad miocárdica, herramienta imprescindible para garantizar el éxito. En los últimos años se han modificado conceptos, se han desarrollado las técnicas de diagnóstico, y la terapéutica, tanto médica como quirúrgica, está en pleno proceso evolutivo. En este artículo comentamos los métodos diagnósticos más útiles para determinar viabilidad miocárdica.
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