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Relatório de estágio em ultrassonografia cardíaca
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| 1.91 MB | Adobe PDF |
Abstract(s)
Resumo - Introdução: A ultrassonografia cardíaca é o exame de imagem mais utilizado na prática
clínica da cardiologia. Consiste no estudo morfológico, funcional e hemodinâmico do coração, permitindo complementar o diagnóstico, modificar a opção terapêutica e estratificar o prognóstico. Objetivo: Realizar um estágio de ultrassonografia cardíaca, no âmbito do Mestrado em Fisiologia Clínica, com o objetivo de analisar variáveis demográficas e ecocardiográficas, bem como discutir 3 interessantes casos clínicos, entre os exames realizados no Ospedale Policlinico San Martino (Génova) e no Hospital Curry Cabral (Lisboa). Resultados: Relativamente à casuística do estágio a amostra é constituída por 304 doentes: 217 em Génova e 87 em Lisboa. Foram recolhidos os dados referentes aos achados ecocardiográficos de 218 ecocardiogramas transtorácicos, 75 ecocardiogramas transesofágicos, 5 ecocardiogramas de sobrecarga farmacológica, 1 ecocardiograma de sobrecarga com exercício físico e 5 ecocardiogramas de contraste. Observaram-se ainda 3
procedimentos percutâneos na sala de hemodinâmica com utilização de ecocardiografia transesofágica como guia. Foram ainda analisados 3 casos clínicos com utilização da ecocardiografia como meio complementar de diagnóstico e como técnica de apoio no tratamento: uma mulher com 75 anos com quadro de insuficiência cardíaca aguda por estenose mitral reumática crónica; um homem com 53 anos com endocardite infecciosa protésica complicada com abcesso intracardíaco e metastização hepática; uma mulher com 59 anos submetida a procedimento percutâneo com utilização da ecocardiografia transesofágica como guia no tratamento da válvula tricúspide, por insuficiência tricúspide massiva. Discussão: A análise da casuística mostrou que o ecocardiograma transtorácico foi o estudo mais realizado, em ambos os hospitais. Das alterações ecocardiográficas patológicas encontradas, verificou-se maior frequência no sexo masculino em Génova e
no sexo feminino em Lisboa, e maioritariamente com idades ≥ 60 anos, em ambos os hospitais. O estudo dos três casos clínicos apresentados enfatizou a importância da ecocardiografia nas várias etapas do processo clínico do doente. A concretização do estágio permitiu a consolidação de conhecimentos e a aquisição de
novas competências. Conclusão: A ultrassonografia é a técnica de imagem de primeira linha da cardiologia no
diagnóstico e tratamento de inúmeras patologias de origem cardíaca e patologias sistémicas com atingimento cardíaco, como foi reforçado pelos 3 casos clínicos apresentados.
Abstract - Introduction: Cardiac ultrasonography is the most used imaging test in clinical cardiology practice. It consists of the morphological, functional and hemodynamic study of the heart, allowing to complement the diagnosis, modify the therapeutic option and stratify the prognosis. Objective: Carry out an internship in cardiac ultrasonography, within the scope of the master’s degree in Clinical Physiology, with the aim of analyzing demographic and echocardiographic variables, as well as discussing 3 interesting clinical cases within the exams carried out at the Ospedale Policlinico San Martino (Genoa) and Hospital Curry Cabral (Lisbon). Results: Regarding the internship casuistic, the sample consists of 304 patients: 217 from Genoa and 87 from Lisbon. Data regarding echocardiographic findings was collected from 218 transthoracic echocardiograms, 75 transesophageal echocardiograms, 5 pharmacological stress echocardiograms, 1 exercise stress echocardiogram and 5 contrast echocardiograms. Three percutaneous procedures were also observed in the hemodynamics room using transesophageal echocardiography as a guide.Three clinical cases were also analyzed using echocardiography as a complementary means of diagnosis and as a support technique in treatment: a 75-year-old woman with acute heart failure due to chronic rheumatic mitral stenosis; a 53-year-old man with prosthetic valve endocarditis complicated by an intracardiac abscess and liver metastasis; a 59-year-old woman undergoing a percutaneous procedure using transesophageal echocardiography as a guide in the treatment of the tricuspid valve, due to massive tricuspid regurgitation. Discussion: The case series analysis showed that transthoracic echocardiography was the most frequently performed study in both hospitals. Within the found pathological echocardiographic changes, there was a higher frequency in males in Genoa and in females in Lisbon, and the majority were aged ≥ 60 years, in both hospitals. The study of the three presented clinical cases emphasized the importance of echocardiography in the various stages of the patient's medical procedure. Carrying out the internship allowed the consolidation of knowledge and the acquisition of new skills.Conclusion: Ultrasonography is the first-line cardiology imaging technique in the diagnosis and treatment of numerous pathologies of cardiac origin and systemic pathologies with cardiac involvement, as reinforced by the three presented clinical cases.
Abstract - Introduction: Cardiac ultrasonography is the most used imaging test in clinical cardiology practice. It consists of the morphological, functional and hemodynamic study of the heart, allowing to complement the diagnosis, modify the therapeutic option and stratify the prognosis. Objective: Carry out an internship in cardiac ultrasonography, within the scope of the master’s degree in Clinical Physiology, with the aim of analyzing demographic and echocardiographic variables, as well as discussing 3 interesting clinical cases within the exams carried out at the Ospedale Policlinico San Martino (Genoa) and Hospital Curry Cabral (Lisbon). Results: Regarding the internship casuistic, the sample consists of 304 patients: 217 from Genoa and 87 from Lisbon. Data regarding echocardiographic findings was collected from 218 transthoracic echocardiograms, 75 transesophageal echocardiograms, 5 pharmacological stress echocardiograms, 1 exercise stress echocardiogram and 5 contrast echocardiograms. Three percutaneous procedures were also observed in the hemodynamics room using transesophageal echocardiography as a guide.Three clinical cases were also analyzed using echocardiography as a complementary means of diagnosis and as a support technique in treatment: a 75-year-old woman with acute heart failure due to chronic rheumatic mitral stenosis; a 53-year-old man with prosthetic valve endocarditis complicated by an intracardiac abscess and liver metastasis; a 59-year-old woman undergoing a percutaneous procedure using transesophageal echocardiography as a guide in the treatment of the tricuspid valve, due to massive tricuspid regurgitation. Discussion: The case series analysis showed that transthoracic echocardiography was the most frequently performed study in both hospitals. Within the found pathological echocardiographic changes, there was a higher frequency in males in Genoa and in females in Lisbon, and the majority were aged ≥ 60 years, in both hospitals. The study of the three presented clinical cases emphasized the importance of echocardiography in the various stages of the patient's medical procedure. Carrying out the internship allowed the consolidation of knowledge and the acquisition of new skills.Conclusion: Ultrasonography is the first-line cardiology imaging technique in the diagnosis and treatment of numerous pathologies of cardiac origin and systemic pathologies with cardiac involvement, as reinforced by the three presented clinical cases.
Description
Keywords
ultrassonografia cardíaca ecocardiografia diagnóstico terapêutica cardiac ultrasonography echocardiography diagnosis treatment