jueves, 14 de mayo de 2009

Caso Clínico 6

Paciente de 80 años asintomático con antecedentes de HTA controlada con combinación IECA +diurético, en el que se pide placa de tórax para preoperatorio de cataratas. Se muestran la placas ¿Cual es el dg? ¿tratamiento?

La respuesta ,el domingo dia 17

14 comentarios:

  1. me imagino aterosclerosis por hiperlipidemia entonces alguna estatina, soy ortopedista asi que no es mi fuerte, saludos desde mexico, ingreso para enlazarme al otro blog de la influenza h1n1

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  2. Joer, pues yo en esa placa no veo nada que me llame la atención... ¿es grave?

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  3. Hay ensanchamiento mediastínico en la postero-anterior y en la lateral se observa un crecimiento supracardiaco y antero-aórtico.

    Podría tratarse de un aneurisma de aorta ascendente o de aurícula dcha.

    Creo que se podría operar de las cataratas y no hacer nada con el aneurisma.

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  4. Suscribo lo dicho por saname.
    Alguien...esperemos que el que vea la radiografía no vea el aneurisma y no lo de por intervenir en él...

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  5. Efectivamente, saname y javithink, es un aneurisma de aorta ascendente, que además ha crecido en los últimos 8 meses casi un cm.
    Sigue traamiento con carvedilol y un ARA 2 por intolerancia a IECAS.
    En la placa se aprecia la dilatación ded la aorta ascendente perfectamente en la placa lateral.Enhorabuena a los sagaces clínicos y gracias a todos por participar.
    P.D. Velaré porque nadie intente operarle ó si lo intentan que no acepte.

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