What's a heart attack?. A myocardial infarction is caused by the reduction or insufficiency of blood flow to the heart muscle as a result of a thrombus narrowing or blocking the coronary arteries that supply it.

The intervention of a specialised team of doctors in the first 120 minutes after the symptoms are detected significantly reduces the possible consequences of a myocardial infarction.

For this reason, when the infarction code is activated, a team of interventional cardiologists from Clinica Rotger is ready to receive the patient and assess his condition and take action as soon as possible. Either by preparing for the application of fibrinolysis techniques to dissolve the clot or by preparing the haemodynamic room for angioplasty, if necessary with stent implantation.

Severe aortic stenosis is a condition in which the aortic valve does not open and close properly, hindering blood flow and causing symptoms such as fatigue, chest pain and dizziness, due to heart failure from overloading. Transcatheter aortic valve implantation, or TAVI, provides an alternative for patients who, due to age or certain surgical risks, are inoperable by open surgery.

The procedure is usually performed by inserting catheters either through the patient's femoral artery, transthoracic or transapical via a small incision under the chest to reach the damaged aortic valve.

Through this incision, the biological valve mounted on a metal mesh (stent) is introduced, which with the help of a transport device (balloon catheter or delivery catheter) is placed on the diseased native aortic valve. The procedure is performed with an X-ray imaging system in the cath lab. With this technique it is possible to restore the normal outflow of blood from the left side of the heart and improve the patient's clinical situation.

Advantages of TAVI

This technique simplifies the procedure. There is no need for an open surgical procedure, which lengthens the hours of surgery and avoids the need for a heart-lung machine. In some cases, anaesthesia is not necessary and the surgery can be performed under sedation. In addition, the patient's postoperative process is reduced in terms of ICU stay and hospital admission time. Less care and postoperative care is also required.

After the intervention, the patient's survival is significantly increased and he/she experiences an improvement in quality of life, with less need for hospital readmissions, less angina and less heart failure.

Early studies on the results of this technique report that two years after valve implantation, 94% of patients maintain high functional capacity. This is of great importance in critically ill patients who, due to their delicate state of health, would not have had access to effective treatment.

Cryoablation is a procedure by which, through the application of a cold balloon of nitrous oxide, it is possible with a single impact to isolate the abnormal electrical impulses of the heart in the pulmonary veins, which are the cause of arrhythmias. This prevents them from being transmitted to the atria.

The technique is faster and achieves similar results in terms of eliminating arrhythmias, reducing complications that can occur with other therapeutic options.

It is performed in a hybrid operating theatre, under sedation and without general anaesthesia. Subsequently, hospitalisation is required, which under normal conditions does not exceed 48 hours.

Reconocimiento cardiológico en la Unidad de Cardiología Deportiva de la Clínica Rotger.

En un reconocimiento cardiológico deportivo se evalúa:

· Historia clínica médico-deportiva, además de los puntos habituales (antecedentes, sintomatología, …) incidiendo especialmente en las cargas de trabajo de la persona.

· Exploración física, con especial atención al sistema cardiovascular (soplos, …)

· Analítica de sangre, que ayuda a evaluar el estado nutricional del deportista, así como a detectar anomalías que pueden afectar al rendimiento (anemia, …) e indicios de fatiga.

· Electrocardiograma: siguiendo las recomendaciones de la Sociedad Europea de Cardiología, como herramienta básica para la valoración de problemas cardiacos.

· Ecocardiograma: proporciona información anatómica y funcional completa. Se trata de una prueba imprescindible para la detección de: miocardiopatías (que son la principal causa de muerte súbita en jóvenes), valvulopatías, enfermedades de la aorta o anomalías en el origen de las arterias coronarias. Además, permite al médico valorar el grado de adaptación a las cargas de trabajo referidas.

· Prueba de esfuerzo o ergometría que, mediante la aplicación de una carga de trabajo, medible y dosificable, valora la capacidad y respuesta del organismo durante el ejercicio físico. Por otra parte, posibilita en ocasiones desenmascarar patología (coronarias o arrítmicas) no observables en reposo. Si el deportista o su técnico así lo desean, el estudio se complementa con la ergoespirometria, una prueba de esfuerzo especial en la que también se codifican datos sobre el intercambio gaseoso respiratorio y la ventilación pulmonar, que aportan información muy valiosa para personalizar los entrenamientos y establecer estrategias en competición.

· Conocer la historia médicodeportiva de cada atleta.

Con el análisis global de los datos obtenidos, se puede elaborar un exhaustivo informe médico que permita la mejor programación de la preparación física y optimizar el volumen e intensidad de la carga de entrenamiento, para obtener el máximo rendimiento deportivo y sobretodo hacer ejercicio físico con mayores garantías.

Así, la cardiología deportiva emerge como una herramienta que busca preservar y prevenir cualquier efecto negativo en la salud del deportista. El estudio clínico de la capacidad y rendimiento de cada atleta, sirve para mejorar los resultados del deportista, a partir de la obtención de información objetiva sobre sus posibilidades físicas.