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Inicio Revista Española de Geriatría y Gerontología Disnea de causa no aclarada en una paciente de 81 años
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Vol. 36. Núm. 5.
Páginas 297-301 (enero 2001)
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Vol. 36. Núm. 5.
Páginas 297-301 (enero 2001)
Acceso a texto completo
Disnea de causa no aclarada en una paciente de 81 años
Unexplained dyspnea in an 81 year old patient
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F.J. Castellote Varona*
Equipo de Valoración y Cuidados Geriátricos. Hospital Universitario Virgen de la Arrixaca. Murcia
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Resumen

A continuación describimos un caso de disnea súbita en una mujer de 81 años con fractura de cadera. En pacientes con enfermedades potencialmente letales debemos llegar a un diagnóstico definitivo. Si el curso clínico y algunos hallazgos son incongruentes con el diagnóstico de presunción deberemos replantearnos el diagnóstico. Hay que tener una alta sospecha de tromboembolismo pulmonar ante la aparición de taquipnea inexplicable. Este caso sirve para recordar las múltiples enfermedades de presentación inespecífica y diagnóstico difícil en el anciano.

Palabras clave:
Disnea
Ancianos
Embolismo de pulmón
Insuficiencia cardíaca
Presentación atípica
Summary

. Herein we describe a case of sudden dyspnea in an 81 year old woman with a hip fracture. In patients with potentially life threatening diseases, we must obtain a definitive diagnosis. When the clinical evolution and some findings are incongruent with the presumed diagnosis, we must reexamine the diagnosis. Pulmonary embolism must be highly suspected in a patient with unexplained recent tachypnea. This case serves to review the multiple diseases with non-specific presentation which are difficult to diagnose in the elderly.

Key words:
Dyspnea
Elderly
Pulmonary embolism
Heart failure
Atypical presentation
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Bibliografía
[1.]
G.L. Lu-Yao, J.A. Baron, J.A. Barret, E.S. Fisher.
Treatment and survival among elderly Americans with hip fractures: a population-based study.
Am J Pub Health, 84 (1994), pp. 1287-1291
[2.]
P.O. Hansson, L. Welin, G. Tibblin, H. Eriksson.
Deep vein thrombosis and pulmonary embolism in the general population: the study of men born in 1913.
Arch Intern Med, 157 (1997), pp. 1665-1670
[3.]
R.M. Siddique, M.I. Siddique, A.F. Connors, A.A. Rimm.
Thirty-day case-fatality rates for pulmonary embolism in the elderly.
Arch Intern Med, 156 (1996), pp. 2343-2347
[4.]
K.M. Moser.
Venous thromboembolism.
Am Rev Respir Dis, 141 (1990), pp. 235-249
[5.]
H. Uhland, L.M. Goldberg.
Pulmonary embolism: a commonly missed clinical entity.
Dis Chest, 45 (1964), pp. 533-536
[6.]
D.D. Tresch.
The clinical diagnosis of heart failure in older patients.
J Am Geriatr Soc, 45 (1997), pp. 1128-1133
[7.]
R.G. Badgett, C.R. Lucey, C.D. Mulrow.
Can the clinical examination diagnose left-sided heart failure in adults?.
JAMA, 277 (1997), pp. 1712-1719
[8.]
M.R. Pratter, T. Bartter.
Dyspnea: Time to find the facts.
Chest, 100 (1991), pp. 1187
[9.]
B. Modan, E. Sharon, N. Jelin.
Factors contributing to the incorrect diagnosis of pulmonary embolic disease.
Chest, 62 (1972), pp. 388-393
[10.]
W. Busby, A. Bayer, J. Pathy.
Pulmonary embolism in the elderly.
Age Ageing, 17 (1988), pp. 205-209
[11.]
P.D. Stein, C. Athanasoulis, A. Alavi, R.H. Greenspan, C.A. Hales, H.A. Saltzman.
Complications and validity of pulmonary angiography in acute pulmonary embolism.
Circulation, 85 (1992), pp. 462-468
[12.]
F. Pigorini, C.L. Maini, F. Pau, S. Biosue.
The influence of age on the pulmonary clearance of Tc99 m DTPA radioaerosol.
Nucl Med Commun, 9 (1988), pp. 965-971
[13.]
A. Gottschalk, H.D. Sostman, R.E. Coleman.
Ventilation-perfusion scintigraphy in the PIOPED study. II. Evaluation of the scintigraphic criteria and interpretation.
J Nucl Med, 34 (1993), pp. 1129-1136
[14.]
R.C. Bone.
The low-probability lung scan: a potentially lethal reading.
Arch Intern Med, 153 (1993), pp. 2621-2622
[15.]
R.D. Hull, G.E. Raskob, G.F. Pineo, R.F. Brant.
The low probability lung scan: a need for change in nomenclature.
Arch Intern Med, 155 (1995), pp. 51
[16.]
R.D. Hull, J. Hirsh, C.J. Carter, R.M. Jay, P.E. Dodd, P.A. Ockelford.
Pulmonary angiography, ventilation lung scanning, and venography for clinically suspected pulmonary embolism with abnormal perfusion lung scan.
Ann Intern Med, 98 (1983), pp. 891-899
[17.]
S.Z. Goldhaber.
Pulmonary Embolism.
N Eng J Med, 339 (1998), pp. 93-104
[18.]
E.D. Chan, C.H. Welsh.
Geriatric Respiratory Medicine.
Chest, 114 (1998), pp. 1704-1733
[19.]
M.D. Mullins, D.M. Becker, K.D. Hagspiel, J.T. Philbrick.
The role of spiral volumetric computed tomography in the diagnosis of pulmonary embolism.
Arch Intern Med, 160 (2000), pp. 293-298
[20.]
A. Perrier, S. Desmarais, C. Goehring, P. de Moerloose, A. Morabia, P.F. Unger.
D-dimer testing for suspected pulmonary embolism in outpatients.
Am J Respir Crit Care Med, 156 (1997), pp. 492-496
[21.]
D.A. Quinn, R.B. Fogel, C.D. Smith, M. Laposata, B. Taylor Thompson, S.M. Johnson.
D-dimers in the diagnosis of pulmonary embolism.
Am J Respir Crit Care Med, 159 (1999), pp. 1445-1449
[22.]
I. Kutinsky, S. Blakley, V. Roche.
Normal D-dimer levels in patients with pulmonary embolism.
Arch Intern Med, 159 (1999), pp. 1569-1572
[23.]
S. Noble, D.H. Peters, K.L. Goa.
Enoxaparin.
Drugs, 49 (1995), pp. 388-410
[24.]
Y.R. Miller, P.F. Bray.
Through thick and thin.
N Eng J Med, 23 (1998), pp. 1684-1688
[25.]
J. Mateo, A. Oliver, M. Borrell, N. Sala, J. Fontcuberta.
Laboratory evaluation and clinical characteristics of 2132 consecutive unselected patients with venous thromboembolism. Results of the spanish multicentric study on thrombophilia (EMET study).
Thromb Haemost, 77 (1997), pp. 444-451
[26.]
D. Mari, P.M. Mannucci, R. Coppola, B. Bottasso, K.A. Banuer, R.D. Rosenberg.
Hypercoagulability in centenarians: the paradox of succesful aging.
Blood, 85 (1995), pp. 3144-3149
[27.]
R.J. Ward, A.G. Tolas, R.J. Benveniste.
Effect of posture on normal arterial blood gas tensions in the aged.
Geriatrics, 21 (1966), pp. 139-143
[28.]
C.M. Harper, Y.M. Lyles.
Physiology and complications of bed rest.
J Am Geriatr Soc, 36 (1988), pp. 1047-1054
[29.]
J.R. Webster, T. Cain.
Pulmonary disease.
Geriatric Medicine, pp. 653-665
[30.]
J.F. Lewis, B.J. Maron.
Clinical and morphologic expression of hypertrophic cardiomyopathy in patients > 65 years of age.
Am J Cardiol, 73 (1994), pp. 1105-1111
[31.]
G. Kleiner-Fisman, H.S. Kott.
Myasthenia gravis mimicking stroke in elderly patients.
Mayo Clin Proc, 73 (1998), pp. 1077-1078
[32.]
P.G. Jarret, K. Rockwood, D. Carver, P. Stolee, S. Cosway.
Illness presentation in elderly patients.
Arch Intern Med, 155 (1995), pp. 1060-1064
[33.]
A.J. Rowan.
Reflections on the treatment of seizures in the elderly population.
Neurology, 51 (1998), pp. S28-S33
[34.]
S. Mokshagundam, U.S. Barzel.
Thyroid disease in the elderly.
J Am Geriatr Soc, 41 (1993), pp. 1361-1369
[35.]
P. Chassagne, M.B. Perol, J. Doucet, C. Trivalle, J.F. Menard, N.D. Manchon.
Is presentation of bacteriemia in the elderly the same as in younger patients?.
Am J Med, 100 (1996), pp. 65-70
[36.]
M. Korzeniewska-Kosela, J. Krysl, N. Müller, W. Black, E. Allen, J.H. Fitzberald.
Tuberculosis in young adults and the elderly. A prospective comparison study.
Chest, 106 (1994), pp. 28-32
[37.]
C. Zamarron, M. Salgueiro, J.M. Álvarez, Y. Otero, J.R. Rodríguez Suarez.
Características clínicas de la tuberculosis pulmonar en el anciano.
An Med Intern (Madrid), 14 (1997), pp. 167-169
[38.]
G.S. Werner, R. Schulz, J.B. Fucchs, S. Andreas, H. Prange, W. Ruschewsk.
Infective endocarditis in the elderly in the era of transesophageal echocardiography: clinical features and prognosis compared with younger patients.
Am J Med, 100 (1996), pp. 90-97
[39.]
A.K. Duncan, J. Vittone, K.C. Fleming, H.C. Smit.
Cardiovascular disease in elderly patients.
Mayo Clin Proc, 71 (1996), pp. 184-196
[40.]
C.J. Michet, J.M. Evans, K.C. Fleming, J.D. O'Duffy, M.L. Jurisson, G.G. Munder.
Common rheumatologic diseases in elderly patients.
Mayo Clin Proc, 70 (1995), pp. 11205-11214
[41.]
T.J. Wachtel, R.A. Silliman, P. Lamberton.
Prognostic factors in the diabetic hyperosmolar state.
J Am Geriatr Soc, 35 (1987), pp. 737-741
[42.]
D.R. Kauvar.
The geriatric acute abdomen.
Clin Geriatr Med, 9 (1993), pp. 547-558
[43.]
J. Yesavage.
Differential diagnosis between depression and dementia.
Am J Med, 94 (1994),
Copyright © 2001. Sociedad Española de Geriatría y Gerontología
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