Trastornos psiquiátricos frecuentes post infarto agudo al miocardio y su relación pronóstica. Revisión de la literatura.

Autores/as

  • Manuel Mallol Simmonds Departamento de Medicina Interna Sur, Facultad de Ciencias Médicas, Escuela de Medicina. Universidad de Santiago de Chile

DOI:

https://doi.org/10.11565/arsmed.v42i2.656

Palabras clave:

Infarto al miocardio, Enfermedad Cardiovascular, Depresión, Trastornos psiquiátricos, Delirium, Salud y ambiente

Resumen

La enfermedad cardiovascular es la principal causa de muerte a nivel mundial. De ella, el Infarto Agudo al Miocardio (IAM) y el Accidente Cerebrovascular (AVC) se encuentran fuertemente asociados a los cambios ambientales y sociales del último tiempo, tales como aumento de ingesta de comida rápida, sedentarismo, tabaquismo, entre otros. Algunos trastornos psiquiátricos que aparecen a corto y largo plazo posterior al evento coronario agudo tienen una implicancia directa en la morbimortalidad cardiovascular y global. De ellos, la depresión representa el trastorno psiquiátrico más frecuente, pudiendo encontrarse en 3 de cada 10 pacientes que tuvieron un IAM. La depresión aumenta las hospitalizaciones, disminuye la adherencia terapéutica y empeora el pronóstico cardiovascular a largo plazo.  La fisiopatología en lo anterior es explicada en parte por alteraciones en el eje neuroendocrino y la respuesta al estrés, mientras que otros fenómenos permanecen aún desconocidos. Dentro de otros trastornos psiquiátricos asociados a un IAM se encuentran el delirium, ansiedad y trastornos de la personalidad. En función de lo anterior, se hace necesaria la incorporación de un sistema continuo de monitoreo y apoyo en salud mental en este grupo de pacientes para mejorar tanto su pronóstico como la calidad de vida.

Citas

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Publicado

2017-07-02

Número

Sección

Revisión narrativa