<HTML><BODY style="word-wrap: break-word; -khtml-nbsp-mode: space; -khtml-line-break: after-white-space; "><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" face="Arial">Español - Portugués</FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" face="Arial"><BR class="khtml-block-placeholder"></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" face="Arial">Español</FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" face="Arial"><BR class="khtml-block-placeholder"></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" face="Arial">Estimado Dr. Andriy Vorotniak de Buenos Aires, Argentina:</FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" face="Arial">Aquí Andrés Ricardo Pérez Riera de San Pablo, Brasil.</FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; font: normal normal normal 13px/normal Lucida Grande; min-height: 16px; "><FONT class="Apple-style-span" face="Arial" size="3"><SPAN class="Apple-style-span" style="font-size: 12px;"><BR></SPAN></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" face="Arial">¡Buena idea, empecemos!</FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" face="Arial">Acerca de este tema, yo recomendaría el magnífico trabajo del Dr. Shlomo Stern: </FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; font: normal normal normal 13px/normal GB18030 Bitmap; min-height: 17px; "><FONT class="Apple-style-span" face="Arial" size="3"><SPAN class="Apple-style-span" style="font-size: 12px;"><BR></SPAN></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" face="Arial">“Electrocardiogram Still the Cardiologist’s Best Friend". Circulation 2006 113: 753-756</FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; font: normal normal normal 13px/normal Lucida Grande; min-height: 16px; "><FONT class="Apple-style-span" face="Arial" size="3"><SPAN class="Apple-style-span" style="font-size: 12px;"><BR></SPAN></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" face="Arial">Si no tiene acceso al texto completo (u otro colega), se lo puedo enviar. Mi dirección de correo electrónico es <A href="mailto:riera@uol.com.br">riera@uol.com.br</A></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; font: normal normal normal 13px/normal Lucida Grande; min-height: 16px; "><FONT class="Apple-style-span" face="Arial" size="3"><SPAN class="Apple-style-span" style="font-size: 12px;"><BR></SPAN></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" face="Arial">Cordialmente, </FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" face="Arial">Andrés Ricardo Pérez Riera</FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" face="Arial">Chief of Electro-Vectocardiology Sector of the Discipline of Cardiology, ABC Faculty of Medicine (FMABC), Foundation of ABC (FUABC)- Santo André -Sao Paulo - Brazil. Rua Sebastião Afonso 885 - Zip Code: 044417-100- Jardim Miriam S.P.- Brazil</FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" face="Arial"><BR class="khtml-block-placeholder"></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" face="Arial">---------</FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" face="Arial"><BR class="khtml-block-placeholder"></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" face="Arial">Portugués</FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" face="Arial"><BR class="khtml-block-placeholder"></FONT></DIV><DIV style="text-align: justify;margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" face="Arial">Caro Dr. Andriy Vorotniak de Buenos Aires, Argentina , aqui é Andrés Ricardo Pérez Riera de São Paulo Brasil.</FONT></DIV><P align="justify" style="margin: 0.0px 0.0px 0.0px 0.0px; text-align: justify"><FONT class="Apple-style-span" face="Arial"> </FONT></P><DIV style="text-align: justify;margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" face="Arial">Boa idéia vamos começar!</FONT></DIV><DIV style="text-align: justify;margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" face="Arial">Sobre este assunto eu recomendo o magnífico artigo do Dr. Shlomo Stern: </FONT></DIV><DIV style="text-align: justify;margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; font: normal normal normal 13px/normal Arial; min-height: 15px; "><FONT class="Apple-style-span" size="3"><SPAN class="Apple-style-span" style="font-size: 12px;"><BR></SPAN></FONT></DIV><DIV style="text-align: justify;margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" face="Arial">“Electrocardiogram Still the Cardiologist’s Best Friend". Circulation 2006 113: 753-756</FONT></DIV><DIV style="text-align: justify;margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; font: normal normal normal 13px/normal Arial; min-height: 15px; "><FONT class="Apple-style-span" size="3"><SPAN class="Apple-style-span" style="font-size: 12px;"><BR></SPAN></FONT></DIV><DIV style="text-align: justify;margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" face="Arial">Se você naõ tiver acesso ao texto completo (ou outro colega) Eu posso mandá-lo. Meu e-mail é </FONT><A href="mailto:riera@uol.com.br"><FONT class="Apple-style-span" color="#003FC3"><FONT class="Apple-style-span" face="Arial">riera@uol.com.br</FONT></FONT></A></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; font: normal normal normal 12px/normal Helvetica; min-height: 14px; "><FONT class="Apple-style-span" face="Arial"><BR></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" face="Arial">Tudo de bom</FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" face="Arial">Andrés Ricardo Pérez Riera</FONT></DIV><DIV style="text-align: justify;margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" face="Arial">Chefe do Setor de Eletro-vetoacardiografia da Disciplina de Cardiologia, ABC Faculdade de Medicina (FMABC), Fundação do ABC (FUABC)- Santo André -Sao Paulo - Brasil. Rua Sebastião Afonso 885 - CEP: 044417-100- Jardim Miriam S.P.- Brasil</FONT></DIV><FONT class="Apple-style-span" face="Arial"><BR></FONT><DIV> <SPAN class="Apple-style-span" style="border-collapse: separate; border-spacing: 0px 0px; color: rgb(0, 0, 0); font-family: Helvetica; font-size: 12px; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; line-height: normal; text-align: auto; -khtml-text-decorations-in-effect: none; text-indent: 0px; -apple-text-size-adjust: auto; text-transform: none; orphans: 2; white-space: normal; widows: 2; word-spacing: 0px; "><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" face="Arial">--</FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" face="Arial">Dr.</FONT><SPAN class="Apple-converted-space"><FONT class="Apple-style-span" face="Arial"> </FONT></SPAN><FONT class="Apple-style-span" face="Arial">Sergio</FONT><SPAN class="Apple-converted-space"><FONT class="Apple-style-span" face="Arial"> </FONT></SPAN><FONT class="Apple-style-span" face="Arial">Dubner</FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" face="Arial">President</FONT><SPAN class="Apple-converted-space"><FONT class="Apple-style-span" face="Arial"> </FONT></SPAN><FONT class="Apple-style-span" face="Arial">of</FONT><SPAN class="Apple-converted-space"><FONT class="Apple-style-span" face="Arial"> </FONT></SPAN><FONT class="Apple-style-span" face="Arial">Scientific</FONT><SPAN class="Apple-converted-space"><FONT class="Apple-style-span" face="Arial"> </FONT></SPAN><FONT class="Apple-style-span" face="Arial">Committee</FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; font: normal normal normal 13px/normal Lucida Grande; min-height: 16px; ; font-family: Lucida Grande; font-size: 13px; "><FONT class="Apple-style-span" face="Arial" size="3"><SPAN class="Apple-style-span" style="font-size: 12px;"><BR style="font-family: Lucida Grande; font-size: 13px; "></SPAN></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" face="Arial">Dr.</FONT><SPAN class="Apple-converted-space"><FONT class="Apple-style-span" face="Arial"> </FONT></SPAN><FONT class="Apple-style-span" face="Arial">Edgardo</FONT><SPAN class="Apple-converted-space"><FONT class="Apple-style-span" face="Arial"> </FONT></SPAN><FONT class="Apple-style-span" face="Arial">Schapachnik</FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" face="Arial">President</FONT><SPAN class="Apple-converted-space"><FONT class="Apple-style-span" face="Arial"> </FONT></SPAN><FONT class="Apple-style-span" face="Arial">of</FONT><SPAN class="Apple-converted-space"><FONT class="Apple-style-span" face="Arial"> </FONT></SPAN><FONT class="Apple-style-span" face="Arial">Steering</FONT><SPAN class="Apple-converted-space"><FONT class="Apple-style-span" face="Arial"> </FONT></SPAN><FONT class="Apple-style-span" face="Arial">Committee</FONT></DIV><DIV><FONT class="Apple-style-span" face="Arial"><BR class="khtml-block-placeholder"></FONT></DIV><DIV><FONT class="Apple-style-span" face="Arial"><BR class="khtml-block-placeholder"></FONT></DIV></SPAN></DIV><DIV><BLOCKQUOTE type="cite"><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; min-height: 14px; "><FONT class="Apple-style-span" face="Arial"><BR></FONT></DIV> <FONT class="Apple-style-span" color="#090909"><FONT class="Apple-style-span" face="Arial">Español - Portugués</FONT></FONT><DIV><FONT class="Apple-style-span" color="#090909"><FONT class="Apple-style-span" face="Arial"><BR class="khtml-block-placeholder"></FONT></FONT></DIV><DIV><FONT class="Apple-style-span" color="#090909"><FONT class="Apple-style-span" face="Arial">Español</FONT></FONT></DIV><DIV><FONT class="Apple-style-span" color="#090909"><FONT class="Apple-style-span" face="Arial"><BR class="khtml-block-placeholder"></FONT></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" color="#090909"><FONT class="Apple-style-span" face="Arial">Estimados colegas,</FONT></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; font: normal normal normal 12px/normal Arial; min-height: 14px; "><FONT class="Apple-style-span" color="#090909"><BR></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" color="#090909"><FONT class="Apple-style-span" face="Arial">Gracias por las respuestas a mi pregunta sobre «palpitaciones» y síndrome de Brugada.</FONT></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" color="#090909"><FONT class="Apple-style-span" face="Arial">El problema de síncopes y «palpitaciones» tiene mucha importancia, sobre todo para los médicos que trabajan en las guardias externas (salas de emergencias). En general, cuando se recibe un paciente con palpitaciones, se buscan en el ECG, signos isquémicos, trastornos de conducción o arrítmias. Sin embargo, no se presta mucha atención a las derivaciones precordiales derechas.</FONT></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" color="#090909"><FONT class="Apple-style-span" face="Arial">Varios autores, que presentaron sus fascinantes conferencias en el Simposio actual, mencionan distintos criterios ECG, predictores de MS. Algunos de estos criterios son bastante conocidos y utilizados en la práctica diaria, no obstante, hay otros, que no se conocen tanto ni por los cardiólogos ni, menos todavía, por los médicos generalistas, por ejemplo: variaciones del segmento ST en las derivaciones precordiales derechas, morfología y duración de la onda S en V1-V3, intervalo Tpeak Tend, acortamiento del PR, etc.</FONT></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" color="#090909"><FONT class="Apple-style-span" face="Arial">Dado que las «palpitaciones» constituyen uno de los motivos más frecuentes de las consultas ambulatorias, propongo desarrollar una lista de predictores ECG de la MS, fáciles de aplicar tanto en la guardia externa como en los consultorios de cardiología. </FONT></FONT></DIV><P style="margin: 0.0px 0.0px 0.0px 0.0px"><FONT class="Apple-style-span" color="#090909"><FONT class="Apple-style-span" face="Arial"> </FONT></FONT></P><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" color="#090909"><FONT class="Apple-style-span" face="Arial">Saludo atte,</FONT></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" color="#090909"><FONT class="Apple-style-span" face="Arial">Dr. Andriy Vorotniak (Buenos Aires, Argentina)</FONT></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" color="#090909"><FONT class="Apple-style-span" face="Arial"><BR class="khtml-block-placeholder"></FONT></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" color="#090909"><FONT class="Apple-style-span" face="Arial">------------</FONT></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" color="#090909"><FONT class="Apple-style-span" face="Arial"><BR class="khtml-block-placeholder"></FONT></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" color="#090909"><FONT class="Apple-style-span" face="Arial">Portugués</FONT></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" color="#090909"><FONT class="Apple-style-span" face="Arial"><BR class="khtml-block-placeholder"></FONT></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" color="#090909"><FONT class="Apple-style-span" face="Arial">Prezados colegas,</FONT></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; line-height: 19px; "><FONT class="Apple-style-span" color="#090909"><FONT class="Apple-style-span" face="Arial">Obrigado pelas respostas para as minhas perguntas a respeito de palpitações e síndrome de Brugada</FONT></FONT></DIV><P style="margin: 0.0px 0.0px 0.0px 0.0px; line-height: 19.0px"><FONT class="Apple-style-span" color="#090909"><FONT class="Apple-style-span" face="Arial"> </FONT></FONT></P><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; line-height: 19px; "><FONT class="Apple-style-span" color="#090909"><FONT class="Apple-style-span" face="Arial">O problema de sincopes e palpitações tem muita importância, mais ainda para os médicos que trabalham nos plantões externos (salas de emergências). Em geral, quando se admite um paciente com palpitações, se procura, no ECG, sinais isquêmicos, distúrbios da condução ou arritmias.</FONT></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; line-height: 19px; "><FONT class="Apple-style-span" color="#090909"><FONT class="Apple-style-span" face="Arial">No entanto, não se presta muita atenção as derivações precordiais direitas.</FONT></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; line-height: 19px; "><FONT class="Apple-style-span" color="#090909"><FONT class="Apple-style-span" face="Arial">Vários autores, que apresentaram suas fascinantes conferências no simpósio atual, mencionam distintos critérios ECG, preditores de MS. Alguns destes critérios são bem conhecidos e utilizados na prática diária, no entanto, há outros, que não se conhecem bem nem pelos cardiologistas, e menos ainda pelos clínicos gerais, por exemplo: variações do segmento ST nas derivações precordiais direitas, morfologia e duração da onda S em V1-V3, intervalo Tpeak Tend, PR curto, etc.</FONT></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; line-height: 19px; "><FONT class="Apple-style-span" color="#090909"><FONT class="Apple-style-span" face="Arial">Devido a que as palpitações conceituem um dos motivos mais freqüentes das consultas ambulatoriais, proponho desenvolver uma lista de preditores ECG da MS, fáceis de aplicar no plantão como nos consultórios de cardiologia.</FONT></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; line-height: 19px; "><FONT class="Apple-style-span" color="#090909"><FONT class="Apple-style-span" face="Arial">Saludo atte,</FONT></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; line-height: 19px; "><FONT class="Apple-style-span" color="#090909"><FONT class="Apple-style-span" face="Arial">Dr. Andriy Vorotniak (Buenos Aires, Argentina)</FONT></FONT></DIV><DIV><FONT class="Apple-style-span" face="Arial"><BR class="khtml-block-placeholder"></FONT></DIV><FONT class="Apple-style-span" face="Arial"><BR></FONT></BLOCKQUOTE></DIV><FONT class="Apple-style-span" face="Arial"><BR></FONT></BODY></HTML>