Rev Med UAS
Vol. 11: No. 4. Octubre-Diciembre 2021
ISSN 2007-8013

Insuficiencia cardiaca crónica con fracción de eyección reducida: abordaje teórico, clínico y terapéutico.

Chronic heart failure with reduced ejection fraction: theoretical, clinical and therapeutic approach.

Inzunza-Cervantes Gustavo1,*, Herrera-Gavilanes Juan Ramón1, López-López Roció Milagro2, Ornelas-Aguirre José Manuel3, Vidal-Morales René2, Peña Valenzuela Alibe Natanai4

  1. Instituto Mexicano del Seguro Social, Centro Médico Nacional del Noroeste Hospital de Especialidades No. 2 “Luis Donaldo Colosio Murrieta”, Servicio de Cardiología, Ciudad Obregón, Sonora, México.
  2. Instituto Mexicano del Seguro Social, Centro Médico Nacional del Noroeste Hospital de Especialidades No. 2 “Luis Donaldo Colosio Murrieta”, Servicio de Medicina Interna, Ciudad Obregón, Sonora, México.
  3. Departamento de Ciencias de la Salud, Universidad de Sonora en Ciudad Obregón, Sonora, México.
  4. Instituto Mexicano del Seguro Social, Unidad Medico Familiar No.1 en Ciudad Obregón, Sonora, México.

*Autor de correspondencia:Dr. Gustavo Inzunza-Cervantes
Blvd. Real del Arco, 220. Fraccionamiento Real del Arco, Cp 85150 Ciudad Obregón Sonora.
Correo electrónico: gusinzunza@live.com.mx Teléfono: +52 (66) 7191-9895

DOI http://dx.doi.org/10.28960/revmeduas.2007-8013.v11.n4.008

Texto Completo PDF

Recibido 24 de noviembre 2020, aceptado 25 de mayo 2021

RESUMEN
El síndrome de insuficiencia cardíaca es una entidad de alto impacto sanitario y social. Desencadenada por un desequilibrio entre el gasto cardiaco y las demandas del organismo, que durante las últimas décadas ha presentado grandes y constantes avances que hacen necesaria su frecuente revisión y análisis; su etiología es heterogénea, siendo la hipertensión arterial y la cardiopatía isquémica las principales causas; en su desarrollo se incluyen mecanismos fisiopatológicos que aún no han sido totalmente esclarecidos, las manifestaciones clínicas incluyen una constelación de síntomas inespecíficos ocasionados por alteraciones en la contractilidad miocárdica, el llenado ventricular o por consecuencia de los mecanismos de compensación; el abordaje diagnóstico parte de la sospecha clínica, apoyada en pruebas paraclínicas como la concentración sanguínea del péptido natriuretico, estudios de radiodiagnóstico y ecocardiografía; el plan terapéutico se basa en la prevención y control de factores de riesgo, la modulación farmacológica de la actividad neurohormonal asociado al uso de dispositivos cardiacos implantables cuando sea necesario por la complejidad del caso. La presente revisión narrativa no sistemática tiene como objetivo describir y recopilar la información de investigaciones y publicaciones existentes acerca de esta patología cardiovascular, otorgando un enfoque teórico, clínico y terapéutico aplicable a los tres niveles de atención en salud.
Palabras clave: insuficiencia cardiaca, falla cardiaca, disfunción ventricular, fracción eyección reducida.

ABSTRACT
Heart failure syndrome is an entity with a high health and social impact. It is triggered by an imbalance between cardiac output and the demands of the organism, that during the last decades has presented great and constant advances that require frequent review and analysis; its etiology is heterogeneous, with arterial hypertension and ischemic heart disease the main causes; Its development includes pathophysiological mechanisms that have not yet been fully clarified. The clinical manifestations include a constellation of nonspecific symptoms caused by alterations in myocardial contractility, ventricular filling or as a consequence of compensation mechanisms; the diagnostic approach starts from the clinical suspicion, supported by paraclinical tests such as the blood concentration of the natriuretic peptide, radio-diagnostic studies and echocardiography; The therapeutic plan is based on the prevention and control of risk factors, the pharmacological modulation of neurohormonal activity associated with the use of implantable cardiac devices when necessary due to the complexity of the case. The present non-systematic narrative review aims to describe and compile the information from existing research and publications about this cardiovascular disease, providing a theoretical, clinical and therapeutic approach applicable to the three levels of health care.
Keywords: heart failure, heart failure, ventricular dysfunction, reduced ejection fraction.

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