El síndrome cerebro corazón en la práctica clínica: un enfoque integral desde la imagen cardíaca para el diagnóstico diferencial y el manejo médico
DOI:
https://doi.org/10.37615/retic.v9n1a2Palabras clave:
síndrome cerebro corazón, Tako-tsubo, ictus, neurocardiología, ecocardiografía, resonancia magnética cardíacaResumen
Introducción: El síndrome cerebro corazón (SHS) es una entidad clínica frecuente y de gran trascendencia, caracterizada por la presencia de lesión miocárdica, arritmias o disfunción ventricular aguda secundaria a una injuria neurológica grave. La elevación de troponinas, presente en un alto porcentaje de pacientes, plantea el dilema de distinguir entre una miocardiopatía por estrés neurogénico y un síndrome coronario agudo (SCA) verdadero. Objetivo: Proporcionar al cardiólogo clínico y al especialista en imagen cardíaca un marco de actuación práctico basado en la evidencia científica, en el que las técnicas de imagen no invasivas asumen un papel central para el diagnóstico diferencial y el manejo del SHS. Desarrollo: Se parte de una actualización fisiopatológica integradora que abarca desde los mecanismos neurohumorales clásicos hasta los recientes hallazgos inflamatorios y de predisposición genética. Sobre esta base se delimitan los distintos fenotipos clínicos del SHS y se detalla un abordaje diagnóstico secuencial. Se presentan algoritmos aplicables a la cabecera del paciente que guían la selección e interpretación de cada modalidad de imagen: ecocardiografía transtorácica y transesofágica, resonancia magnética cardíaca y tomografía computarizada. Conclusión: La aplicación estructurada de estos algoritmos permite optimizar la precisión diagnóstica, refinar la estratificación del riesgo y fundamentar un manejo terapéutico personalizado en esta población compleja.
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Derechos de autor 2026 José Alberto Sánchez-Guerra, Pedro María Azcárate Agüero, Miguel Ángel García Fernández
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