Factores de riesgo de claudicación intermitente por arterioesclerosis obliterante, en el Hospital Teodoro Maldonado Carbo, período entre septiembre 2014 a septiembre 2016
Fecha
2017
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Medicina
Resumen
La enfermedad arterial periférica es una importante manifestación de la arteroesclerosis sistémica. Su prevalencia se estima aproximadamente el 12%, aunque varía ampliamente en función de la población estudiada. De acuerdo a los estudios de la presente investigación afecta en mayor medida a hombres que a mujeres.
Por lo general los pacientes en alto riesgo de enfermedad arterial periférica, son: Edad > 70 años; con historia de tabaquismo, hipertensión o diabetes mellitus; síntomas compatibles con claudicación al esfuerzo o dolor isquémico en reposo; pulsos anormales en las extremidades inferiores; enfermedad arteriosclerosa en otros territorios (p. ej., enfermedad arterial coronaria, carotídea o renal), y/o pacientes con un score de Framingham entre el 10 y el 20%.
De acuerdo a las últimas encuestas en Ecuador para el año de 2008 se registraron 148 defunciones por enfermedad arterioesclerótica. Dentro de las causas de mortalidad en el ya mencionado año la enfermedad arterioesclerótica se ubica en el casillero 50.
Para establecer el diagnóstico de la enfermedad arterial periférica se maneja el interrogatorio con el paciente, recalcando los factores de riesgo como tabaquismo, diabetes mellitus, hipertensión arterial, etc. También es importante la exploración física, el índice tobillo-brazo, otros métodos diagnósticos no invasivos (determinaciones de la presión segmentarias, registros del volumen del pulso, estudios de ecografía-Doppler y pruebas de esfuerzo) y la angiografía vascular mediante tomografía computarizada (TC), resonancia magnética (RM) o arteriografía convencional.
El objetivo de la detección temprana de un paciente que ya cataloga con factores de riesgos de enfermedad arterioesclerótica de acuerdo a los criterios ya mencionados, es educar al paciente, tratamiento oportuno lo antes posible para lograr evitar la progresión y lograr cambios en el estilo de vida ya que ciertos factores de riesgo son modificables y en estos hay que hacer hincapié.
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Peripheral arterial disease is an important manifestation of systemic atherosclerosis. Its prevalence is approximately 12%, although it varies widely according to the population studied. It affects usually a men than a women. Usually patients at high risk for peripheral arterial disease, are: Age> 70 years; With history of smoking, arterial hypertension or diabetes mellitus; Symptoms consistent with exertional claudication or resting ischemic pain; Abnormal pulses in the lower extremities; Atherosclerotic disease in other territories (eg, coronary, carotid or renal artery disease), and / or patients with a Framingham score between 10 and 20%. According to the latest surveys in Ecuador for the year 2008, 148 deaths were registered for arteriosclerotic disease. Among the causes of mortality in the aforementioned year, arteriosclerotic disease is located in box 50. In order to establish the diagnosis of peripheral arterial disease, we basically base the questioning with the patient, emphasizing risk factors such as smoking, diabetes mellitus, arterial hypertension, etc. Physical examination, ankle-brachial index, other non-invasive diagnostic methods (segmental pressure measurements, pulse volume registers, Doppler ultrasonography and stress tests) and vascular angiography using computed tomography (CT) are also important.), Magnetic resonance imaging (MRI) or conventional arteriography. The objective of the early detection of a patient who already catalogs with risk factors of arteriosclerotic disease according to the aforementioned criteria is to educate the patient, timely treatment as soon as possible to avoid progression and to achieve changes in lifestyle Since certain risk factors are modifiable and should be emphasized in these.
Peripheral arterial disease is an important manifestation of systemic atherosclerosis. Its prevalence is approximately 12%, although it varies widely according to the population studied. It affects usually a men than a women. Usually patients at high risk for peripheral arterial disease, are: Age> 70 years; With history of smoking, arterial hypertension or diabetes mellitus; Symptoms consistent with exertional claudication or resting ischemic pain; Abnormal pulses in the lower extremities; Atherosclerotic disease in other territories (eg, coronary, carotid or renal artery disease), and / or patients with a Framingham score between 10 and 20%. According to the latest surveys in Ecuador for the year 2008, 148 deaths were registered for arteriosclerotic disease. Among the causes of mortality in the aforementioned year, arteriosclerotic disease is located in box 50. In order to establish the diagnosis of peripheral arterial disease, we basically base the questioning with the patient, emphasizing risk factors such as smoking, diabetes mellitus, arterial hypertension, etc. Physical examination, ankle-brachial index, other non-invasive diagnostic methods (segmental pressure measurements, pulse volume registers, Doppler ultrasonography and stress tests) and vascular angiography using computed tomography (CT) are also important.), Magnetic resonance imaging (MRI) or conventional arteriography. The objective of the early detection of a patient who already catalogs with risk factors of arteriosclerotic disease according to the aforementioned criteria is to educate the patient, timely treatment as soon as possible to avoid progression and to achieve changes in lifestyle Since certain risk factors are modifiable and should be emphasized in these.
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Diabetes mellitus, Hipertensión, Arteriosclerosis obliterante, Claudicación intermitente, Factores de riesgo, Mortalidad, Hospital de Especialidades Dr. Teodoro Maldonado Carbo, Cantón Guayaquil, Ecuador