Articulos Médicos

Insuficiencia cardiaca:

Importancia del trabajo preventivo

JPEG - 10.1 KB
Gregorio A. Cortés-Soto, MD
Principal Oficial Médico MSO of Puerto Rico, Inc. (MSO)

La insuficiencia cardíaca es un cuadro en el cual el corazón no puede bombear suficiente sangre a todo el cuerpo. La insuficiencia cardíaca no significa que el corazón se haya detenido o esté por dejar de funcionar. Indica que el corazón no puede bombear la sangre de la manera como debería hacerlo. El debilitamiento de la capacidad de bombeo del corazón provoca:

  • Acumulación de sangre y líquidos en los pulmones.
  • Acumulación de líquido (edema) en los pies, los tobillos y las piernas.
  • Cansancio y falta de aire.

Causas e incidencia

Las principales causas de insuficiencia cardiaca son enfermedad arterial coronaria, presión arterial alta y diabetes. Su terapia incluye tratar la causa subyacente de la insuficiencia cardiaca, medicinas y, si todas las alternativas fallan, trasplante del corazón. La insuficiencia cardiaca es una condición seria. Aproximadamente 5 millones de personas en los Estados Unidos tienen este cuadro con cerca de 300 mil muertes anuales.

Prevención

Aunque tradicionalmente, la mayor parte de los esfuerzos se han enfocado en el tratamiento de la insuficiencia cardiaca, la realidad es que lo más importante es la prevención. Para esto, debemos evitar que nuestros pacientes lleguen a desarrollar problemas coronarios, hipertensión y diabetes debido a los estilos de vida y los hábitos alimenticios inadecuados. Por otro lado, a los pacientes que ya tienen esas condiciones los mantenemos educados en cuanto a los beneficios de modificar sus estilos de vida y sus hábitos alimenticios para evitar que se deterioren aún más.

El equipo multidisciplinario

Podemos lograr el mayor impacto enseñándole a nuestra juventud los beneficios de una vida saludable y activa. Este esfuerzo compromete también a los padres. Por esto, es cada vez más importante que enfoquemos nuestro trabajo desde un punto de vista multidisciplinario. El médico tiene el rol de dirigir el plan de tratamiento, y los demás profesionales de la salud aportan en sus respectivas áreas de competencia para, entre todos, lograr el objetivo de la prevención.

Alternativas novedosas

Hoy día se cuenta con alternativas como vehículos que recorren la isla y ofrecen pruebas preventivas, centros de llamadas para orientación al paciente sobre situaciones urgentes de salud, material educativo escrito y visual para ser distribuido en oficinas médicas y en los medios, servicios nutricionales accesibles a todos sin importar su cubierta médica, coordinadores de servicios de salud y servicios comunitarios disponibles para la ciudadanía.

Todos estos recursos pueden ser subcontratados y no necesariamente tienen que residir en la oficina médica, ni ser costeados por el médico. Se trata de adoptar el concepto de que todo ser humano que entre a nuestra oficina debe ser evaluado, tratado y seguido por un equipo multidisciplinario de salud dependiendo de sus necesidades específicas, según lo determine el médico y cumpliendo con los protocolos de manejo que dicta la medicina basada en evidencia (evidence based medicine). Solo así tendremos una población más saludable y con menos incidencia de enfermedades crónicas, que aumentan en forma dramática la mortalidad y los costos de la salud.

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