El test cardiológico de anoxemia

It is well known the fundamental importance of the accurate diagnosis of Angina syndrome. According to White, this dindrome constitutes 11.8% of heart disease, demonstrating that it is not that uncommon, especially in recent decades. It is well known, also, the relatively poor prognosis of angina; White on statistics, the average life, after the first attack, only reaches 9.1 years. Finally, it is known that an essential part of preventive treatment of attacks of angina pectoris, is the radical change in lifestyle, which may result, in many cases, very serious consequences for the patient, from the point of view economic and social. This sort of treatment that would interfere primarily in the patient's life and prognosis, as we have said, is relative severity, can only be justified on the basis of a definite diagnosis of the syndrome of angina pectoris.Es perfectamente conocida la importancia fundamental del diagnóstico de certeza del síndrome de Angina de Pecho. Según White, este dindrome constituye el 11.8% de las cardiopatías, lo que demuestra que no es tan infrecuente, sobre todo en las últimas décadas. Es bien sabido, asimismo, el pronóstico relativamente grave de la estenocardia; en la estadística de White, el término medio de vida, después del primer ataque, solo alcanza a 9.1 años. Finalmente, es conocido que, una parte esencial del tratamiento preventivo de los ataques de angor pectoris, es el cambio radical en el modo de vida, lo cual puede acarrear, en muchos casos, consecuencias muy serias para el paciente, desde el punto de vista económico y social. Esta suerte de tratamiento, que interferiría fundamentalmente en la vida del paciente, así como el pronóstico que, como ya hemos dicho, es de relativa gravedad, sólo pueden hacerse justificadamente sobre la base de un diagnóstico indudable del sindrome de angina de pecho

Exercise pathophysiology in patients with chronic mountain sickness exercise in chronic mountain sickness

ABSTRACT: BACKGROUND:Chronic mountain sickness is characterized by a combination of excessive erythrocytosis, severe hypoxemia and pulmonary hypertension, all of which affect exercise capacity. METHODS:Thirteen chronic mountain sickness patients and 15 healthy highlander and 15 newcomer lowlander controls were investigated at an altitude of 4350m (Cerro de Pasco). All of them underwent measurements of lung diffusing capacity for nitric oxide and carbon monoxide at rest, echocardiography for estimation of mean pulmonary arterial pressure and cardiac output at rest and at exercise, and an incremental cycle ergometer cardiopulmonary exercise test. RESULTS:The chronic mountain sickness patients, the healthy highlanders and the newcomer lowlanders reached a similar maximal oxygen uptake, at 32±1, 32±2 and 33±2 ml.min(-1).kg(-1) respectively, mean ± SE, p=0.8, with ventilatory equivalents for CO(2) versus end-tidal PCO(2), measured at the anaerobic threshold, of 0.9±0.1, 1.2±0.1 and 1.4±0.1 mmHg(-1), p<0.001, arterial O(2) content of 26±1, 21±2 and 16±1 ml.dl(-1), p<0.001, diffusing capacity for carbon monoxide corrected for alveolar volume of 155±4, 150±5 and 120±3% predicted, p<0.001, with diffusing capacity for nitric oxide and carbon monoxide ratios of 4.7±0.1 at sea-level decreased to 3.6±0.1, 3.7±0.1 and 3.9±0.1, p<0.05 and a maximal exercise mean pulmonary arterial pressure at 56±4, 42±3, and 31±2 mmHg, p<0.001. CONCLUSIONS:The aerobic exercise capacity of chronic mountain sickness patients is preserved in spite of severe pulmonary hypertension and relative hypoventilation, probably by a combination of increased oxygen carrying capacity of the blood and lung diffusion, the latter being predominantly due to an increased capillary blood volume.JOURNAL ARTICLESCOPUS: ar.jinfo:eu-repo/semantics/publishe