que se leu este artigo
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=> array:15 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Image in Cardiology</span>" "titulo" => "Self-limited massive hematemesis" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "605" "paginaFinal" => "607" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Dimitrios Afendoulis, Athanasios Kartalis, Nikolaos Papagiannis, Maria Moutafi, Petros Voutas, Ioannis Gklotsos, Dimitrios Siskos, Aristodimos Maratsos, Konstantinos Toutouzas" "autores" => array:9 [ 0 => array:4 [ "nombre" => "Dimitrios" "apellidos" => "Afendoulis" "email" => array:1 [ 0 => "dimitrisafendoulis@yahoo.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Athanasios" "apellidos" => "Kartalis" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "Nikolaos" "apellidos" => "Papagiannis" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 3 => array:3 [ "nombre" => "Maria" "apellidos" => "Moutafi" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 4 => array:3 [ "nombre" => "Petros" "apellidos" => "Voutas" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 5 => array:3 [ "nombre" => "Ioannis" "apellidos" => "Gklotsos" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 6 => array:3 [ "nombre" => "Dimitrios" "apellidos" => "Siskos" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] 7 => array:3 [ "nombre" => "Aristodimos" "apellidos" => "Maratsos" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff0020" ] ] ] 8 => array:3 [ "nombre" => "Konstantinos" "apellidos" => "Toutouzas" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">e</span>" "identificador" => "aff0025" ] ] ] ] "afiliaciones" => array:5 [ 0 => array:3 [ "entidad" => "Cardiology Department, General Hospital of Chios “Skylitseio”, Greece" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Gastroenterology Department, General Hospital of Chios “Skylitseio”, Greece" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Vascular Surgery Department, General Hospital of Chios “Skylitseio”, Greece" "etiqueta" => "c" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Radiology Department, General Hospital of Chios “Skylitseio”, Greece" "etiqueta" => "d" "identificador" => "aff0020" ] 4 => array:3 [ "entidad" => "1st Department of Cardiology, Hippokration Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece" "etiqueta" => "e" "identificador" => "aff0025" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Hematemeses maciças autolimitadas" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2002 "Ancho" => 2007 "Tamanyo" => 450578 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A. Endoscopy of the upper gastrointestinal tract, revealing the presence of blood clot at the proximal esophageal tract (red arrow) with erosion from a pulsative mass. B. Computed tomography angiography of aorta and thorax with intravenous contrast agent, axial view, depicting the presence of a saccular descending aortic aneurysm at the level of the tracheal carina, with mural thrombus (red arrow), and an aortoesophageal fistula blocked by a part of the thrombus, protruding into the esophagus lumen (yellow arrow). C. Computed tomography angiography of aorta and thorax, three dimensional reconstruction, depicting the presence of the descending aortic aneurysm. D. Computed tomography angiography of aorta and thorax with intravenous contrast agent, axial view, depicting the presence of a saccular descending aortic aneurysm at the level of the tracheal carina with the presence of air within the thrombus's layers (red arrows). E. Computed tomography angiography of aorta and thorax with intravenous contrast agent, sagittal view, depicting the aneurysm's mural thrombus (red arrow), protruding into the esophagus lumen (yellow arrow). F. Invasive angiography, showing the result of the thoracic endovascular aortic repair procedure with coverage of the aneurysm with endovascular stent graft (red arrow).</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A patient with a medical history of dyslipidemia and arterial hypertension was admitted to the Cardiology department of our hospital due to acute onset chest pain. His vital signs were normal, with no significant findings from the physical examination, ECG, chest X-Ray and heart echocardiogram. D-dimers and HS trop I were mildly elevated. During his hospitalization, the patient suffered an episode of massive hematemesis. After being hemodynamically stabilized four hours later, an urgent endoscopy of the upper gastrointestinal tract revealed the presence of a blood clot at the proximal esophageal tract with erosion from a pulsative mass (<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>A), and a part of the thrombus within the gastric lumen (<a class="elsevierStyleCrossRef" href="#fig0010">Figure 2</a>), with no signs of active hemorrhage due to peptic ulcer or malignancy. An emergent computed tomography angiography of the aorta and thorax showed a saccular descending aortic aneurysm at the level of the tracheal carina with a maximal diameter of 54 mm and mural thrombus. Remarkable was the presence of air within the thrombus's layers, and an aortoesophageal fistula blocked by a part of the thrombus, protruding into the esophagus lumen (<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>B, C, D, E). As a result, a thoracic endovascular aortic repair procedure was performed. The aneurysm was successfully covered with an endovascular stent graft (32 mmx10 cm) (<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>F). The patient had an uneventful post-operative course and was discharged on sixth postoperative day. Our patient was lucky to survive because a potentially life-threatening hematemesis was staunched by the presence of a tamponing thrombus within the lumen of the aortoesophageal fistula.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of interest</span><p id="par0010" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:1 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Conflicts of interest" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2021-06-23" "fechaAceptado" => "2021-08-25" "multimedia" => array:2 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2002 "Ancho" => 2007 "Tamanyo" => 450578 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A. Endoscopy of the upper gastrointestinal tract, revealing the presence of blood clot at the proximal esophageal tract (red arrow) with erosion from a pulsative mass. B. Computed tomography angiography of aorta and thorax with intravenous contrast agent, axial view, depicting the presence of a saccular descending aortic aneurysm at the level of the tracheal carina, with mural thrombus (red arrow), and an aortoesophageal fistula blocked by a part of the thrombus, protruding into the esophagus lumen (yellow arrow). C. Computed tomography angiography of aorta and thorax, three dimensional reconstruction, depicting the presence of the descending aortic aneurysm. D. Computed tomography angiography of aorta and thorax with intravenous contrast agent, axial view, depicting the presence of a saccular descending aortic aneurysm at the level of the tracheal carina with the presence of air within the thrombus's layers (red arrows). E. Computed tomography angiography of aorta and thorax with intravenous contrast agent, sagittal view, depicting the aneurysm's mural thrombus (red arrow), protruding into the esophagus lumen (yellow arrow). F. Invasive angiography, showing the result of the thoracic endovascular aortic repair procedure with coverage of the aneurysm with endovascular stent graft (red arrow).</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 760 "Ancho" => 1005 "Tamanyo" => 99521 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Endoscopy of the upper gastrointestinal tract, depicting the presence of thrombus within the gastric lumen.</p>" ] ] ] ] "idiomaDefecto" => "en" "url" => "/08702551/0000004100000007/v1_202207030541/S0870255122002426/v1_202207030541/en/main.assets" "Apartado" => array:4 [ "identificador" => "85617" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Image in Cardiology" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/08702551/0000004100000007/v1_202207030541/S0870255122002426/v1_202207030541/en/main.pdf?idApp=UINPBA00004E&text.app=https://revportcardiol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255122002426?idApp=UINPBA00004E" ]
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