Bloqueo de rama intermitente revision de tema y abordaje de una entidad clinica compleja
Resumen
Introducción: El bloqueo intermitente de rama del haz de His es un trastorno de la conducción poco común con solo unos pocos casos informados en la literatura, principalmente después de una isquemia miocárdica o un traumatismo cardíaco cerrado o múltiples causas que enumeraremos a lo largo de esta revisión. Presentación del caso: El vasoespasmo coronario como causa principal de bloqueo de rama intermitente ha sido poco informado antes. Presentamos un caso de un hombre de mediana edad con presentación de dolor torácico cardíaco con bloqueo de rama izquierda intermitente en Electrocardiograma. El paciente fue llevado al laboratorio de cateterismo. El angiograma finalmente mostró coronarias con vasoespasmo moderado-severo en la arteria descendente anterior izquierda, que se alivió totalmente tras la colocación de un stent medicado. Discusión y Revisión: El bloqueo de rama intermitente suele presentarse en pacientes con cardiopatía subyacente o enfermedad del sistema de conducción. Hay dos formas de bloqueo de rama aquellos dependientes de la frecuencia: la forma de bloqueo dependiente de la aceleración, en la que se produce un retraso en la conducción cuando la frecuencia cardíaca supera un valor crítico, y el bloqueo dependiente de la desaceleración en el que se produce un retraso en la conducción cuando la frecuencia cardíaca desciende por debajo de un nivel crítico. Conocer este tipo de fenómenos permite una mejor compresión de la fisiopatología de los cambios electrocardiográficos para así abordar oportunamente dicha condición y obtener los mejores resultados posibles.
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Derechos de autor 2023 Juan Sebastián Theran León;Luis Andrés Dulcey Sarmiento;Laura Yibeth Esteban Badillo;Stephania Julieth Nariño Anaya;Marco Sergio Avila Florez ;Wilson David Mantilla Carreño
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