Ruptura del músculo papilar anterolateral, una causa poco común de complicación post isquémica: reporte de caso

Despite the low incidence of mechanical complications in myocardial infarction, the severity of them requires a fast and accurate diagnosis, as well as early treatment, with echocardiography being the leading imaging technique in these cases. Classically, the most frequently affected papillary muscle is the posteromedial one, due to its unique vascularization by the posterior descending artery. We present the case of a patient with rupture of the anterolateral muscle and secondary acute mitral insufficiency as a complication of a previous infarction due to occlusion of the anterior descending artery.A pesar de la baja incidencia de las complicaciones mecánicas del infarto de miocardio, la gravedad que implican exige un rápido y acertado diagnóstico, así como un tratamiento precoz, siendo la ecocardiografía la técnica de imagen protagonista en estos casos. Clásicamente, el músculo papilar más frecuentemente afectado es el posteromedial, por su vascularización única por la arteria descendente posterior. Presentamos el caso de un paciente con ruptura del músculo anterolateral e insuficiencia mitral aguda secundaria como complicación de un infarto anterior evolucionado por oclusión de la arteria descendente anterior

Diagnostic performance of CerTest and Panbio antigen rapid diagnostic tests to diagnose SARS-CoV-2 infection

Objectives Antigen rapid diagnostic tests (Ag-RDT) have been developed as reliable tools to control the SARS-CoV-2 pandemic. The objective of our study was to evaluate the diagnostic performance of two Ag-RDTs. Methods We evaluated CerTest SARS-CoV-2 Ag One Step Card Test and Panbio COVID-19 Ag Rapid Test Device Ag-RDTs. We included 320 nasopharyngeal samples: 150 PCR negative samples to assess the specificity and 170 PCR positive samples to evaluate the sensitivity. We also evaluated their sensitivity according to cycle threshold (Ct) values and the time from the onset of symptoms. Tests were compared using the McNemar?s test and agreement was evaluated using the kappa score (k). Results Both Ag-RDTs showed a specificity of 100 %. Overall sensitivity was 53.5 % for CerTest and 60.0 % for Panbio. For samples with 25, sensitivity was 94.0 % for CerTest and 96.4 % for Panbio (p = 0.500). Regarding samples with Ct>25, sensitivity was 14.0 % for CerTest and 24.4 % for Panbio (p = 0.004). Sensitivity for samples within the first 5 days after the onset of symptoms were 84.8 % for CerTest and 91.3 % for Panbio (p = 0.250) and notably decreased for samples taken after the fifth day. Both Ag-RDTs showed an excellent agreement between them (agreement = 96.7 %, k = 0.920). Agreement with PCR was also excellent for high viral load samples (Ct<25) for CerTest (98.0 %, k = 0.954) and Panbio (98.8 %, k = 0.973). Conclusions CerTest SARS-CoV-2 and Panbio COVID-19 Ag showed excellent performance and agreement results for samples with high viral loads (Ct 25) or samples taken within the first 5 days after the onset of symptoms