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Enfermedad Coronaria

¿Qué es y cómo se trata?

La Enfermedad Coronaria es una patología que afecta especialmente a las arterias que suministran sangre al corazón. Se produce cuando estas vías se van angostando por la acumulación de placa, formada por el colesterol, los depósitos de grasa, calcio u otras sustancias. Este depósito de placa también puede producirse en las arterias carótidas (que suministran sangre y oxígeno al cerebro) o en las que llevan sangre a las piernas, brazos y pelvis.

¿Cómo se produce?

Factores como el tabaquismo, colesterol, presión alta o diabetes pueden producir lesiones en las paredes de la arteria, lo que a su vez provoca rigidez arterial (que se conoce como arterioesclerosis). A partir de esas lesiones el cuerpo trata de protegerse, y provoca una mayor acumulación de placa en las arterias dañadas.

Con el tiempo la placa va reduciendo o directamente bloqueando por completo la arteria, reduciendo el flujo de sangre rica en oxígeno que debería llegar al músculo cardíaco. En otras ocasiones la placa se rompe y puede formar un coágulo de sangre, que reduce o tapona las arterias. Esto produce dolor en el pecho (angina) o directamente un infarto agudo de miocardio (ataque al corazón). Otros factores que influyen son la menopausia, el envejecimiento o un historial familiar de problemas cardíacos.

¿Cuáles son los síntomas?

Dos de cada tres personas que tuvieron un infarto recuerdan haber sufrido dolores severos en el pecho, dificultades para respirar o fatiga. El síntoma más típico es el dolor en el medio del pecho que se extiende hacia la espalda, la mandíbula, el brazo izquierdo o a veces el derecho. Con menor frecuencia el dolor se percibe en el abdomen y puede confundirse con una indigestión. En caso de tener estos síntomas se debe buscar atención médica lo antes posible.

¿Cómo se realiza el diagnóstico?

Hay varias maneras:

  • Con un electrocardiograma, también conocido como ECG, que mide la actividad eléctrica del corazón y puede mostrar si ha sido dañado por el infarto.
  • Con una prueba de esfuerzo, que mide la actividad eléctrica del corazón mientras se realiza actividad física.
  • Con un angiograma coronario, que puede mostrar las obstrucciones o estrechamientos de las arterias (generalmente se inyecta un líquido de contraste, que muestra el estado en que se encuentran estas vías).

¿En que consiste el tratamiento? 

El tratamiento dependerá de la gravedad del paciente, pero siempre deberá ser acompañado de un cambio de estilo de vida, ejercicio y dieta. Hay medicamentos que alivian el dolor en el pecho debido a los bloqueos, pero que no lo tratan en si mismos. Dentro de los procedimientos médicos podemos señalar los siguientes:

  • La angioplastia: es un procedimiento no quirúrgico que se realiza en un hospital. El médico inserta un tubito especial muy fino (catéter) a través de la ingle o en el brazo, que luego pasa a través de las arterias hasta llegar al sitio donde se detectó la obstrucción. En la punta del catéter hay un pequeño balón, que se infla lentamente y libera ese obstáculo.
  • Muchos pacientes que tienen que someterse a una angioplastia también pueden colocarse un stent, una especie de malla metálica que permite volver a expandir la arteria y llevarla a su tamaño normal. El stent permanece en la arteria para ayudar a mantener el flujo de sangre, y con el tiempo la pared afectada se cura a su alrededor.
  • Finalmente, se puede realizar un By Pass coronario, un procedimiento que requiere de una cirugía a corazón abierto para reconstruir las arterias o las venas afectadas con otras sanas, que se toman de otras partes del cuerpo.
  • En todos estos procedimientos existen riesgos asociados, por lo que es muy importante realizar consultas con un médico especializado.

Prevención 

Para prevenir la enfermedad coronaria, se recomienda dejar de fumar, bajar el colesterol, realizar ejercicios regularmente, comer en forma saludable, mantener la presión arterial en niveles adecuados, y la diabetes bajo control. Por último, y no menos importante visitar regularmente al médico.