{"id":1981,"date":"2026-04-16T10:03:06","date_gmt":"2026-04-16T13:03:06","guid":{"rendered":"https:\/\/hospitalsanroque.gob.ar\/?p=1981"},"modified":"2026-04-16T10:03:06","modified_gmt":"2026-04-16T13:03:06","slug":"protocolo-de-valoracion-cardiologica-prequirurgica-pediatrica-hmisr-2025","status":"publish","type":"post","link":"https:\/\/hospitalsanroque.gob.ar\/index.php\/2026\/04\/16\/protocolo-de-valoracion-cardiologica-prequirurgica-pediatrica-hmisr-2025\/","title":{"rendered":"Protocolo de Valoraci\u00f3n Cardiol\u00f3gica Prequir\u00fargica Pedi\u00e1trica -HMISR-2025"},"content":{"rendered":"\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<p><em>Este es un documento gu\u00eda elaborado por el Servicio de Cardiolog\u00eda del Hospital Materno Infantil San Roque y emitido con la aprobaci\u00f3n de la Direcci\u00f3n durante el mes de mayo de 2025.<\/em><\/p>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<h2 class=\"wp-block-heading\">\u00cdndice<\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li><a href=\"https:\/\/historico.hospitalsanroque.gob.ar\/seccion\/articulos\/471\/protocolo-de-valoracion-cardiologica-prequirurgica#mcetoc_1irs8bs5di\">1.-Objetivo<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/historico.hospitalsanroque.gob.ar\/seccion\/articulos\/471\/protocolo-de-valoracion-cardiologica-prequirurgica#mcetoc_1irs855bu1d\">2.- Fundamento<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/historico.hospitalsanroque.gob.ar\/seccion\/articulos\/471\/protocolo-de-valoracion-cardiologica-prequirurgica#mcetoc_1irs855bu1e\">3.- Indicaciones para interconsulta con cardiolog\u00eda pedi\u00e1trica<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/historico.hospitalsanroque.gob.ar\/seccion\/articulos\/471\/protocolo-de-valoracion-cardiologica-prequirurgica#mcetoc_1irs855bu1m\">4.- Bibliograf\u00eda respaldatoria\u00a0<\/a><\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\" id=\"mcetoc_1irs8bs5di\"><strong>1.-Objetivo<\/strong><\/h3>\n\n\n\n<p>Definir criterios claros para solicitar evaluaci\u00f3n cardiol\u00f3gica previa a cirug\u00eda en pacientes pedi\u00e1tricos, optimizando recursos y reduciendo riesgos anest\u00e9sicos.&nbsp;<\/p>\n\n\n\n<h3 class=\"wp-block-heading\" id=\"mcetoc_1irs855bu1d\"><strong>2.- Fundamento<\/strong><\/h3>\n\n\n\n<p>El riesgo cardi\u00e1co perioperatorio en pediatr\u00eda es bajo en pacientes sanos, pero se incrementa en presencia de cardiopat\u00edas estructurales o funcionales no diagnosticadas. La evaluaci\u00f3n por el especialista permite estratificar riesgos, optimizar el manejo anest\u00e9sico y definir si se requieren estudios adicionales.&nbsp;<\/p>\n\n\n\n<p>Las recomendaciones actuales de la Sociedad Argentina de Pediatr\u00eda (SAP) y la American Heart Association (AHA) sugieren realizar una evaluaci\u00f3n dirigida, evitando estudios innecesarios en pacientes asintom\u00e1ticos sin antecedentes.&nbsp;<\/p>\n\n\n\n<h3 class=\"wp-block-heading\" id=\"mcetoc_1irs855bu1e\"><strong>3.- Indicaciones para interconsulta con cardiolog\u00eda pedi\u00e1trica<\/strong><\/h3>\n\n\n\n<p><em>Se solicitar\u00e1 evaluaci\u00f3n clinica cardiol\u00f3gica y\/o ECG&nbsp;<\/em><strong><em>en los siguientes casos:<\/em><\/strong><\/p>\n\n\n\n<h4 class=\"wp-block-heading\" id=\"mcetoc_1irs855bu1f\"><strong>&#8211; Antecedentes personales conocidos de cardiopat\u00eda;<\/strong><\/h4>\n\n\n\n<ol class=\"wp-block-list\">\n<li>Cardiopat\u00eda cong\u00e9nita\u00a0<em>(resuelta o no);<\/em><\/li>\n\n\n\n<li>Arritmias previas o actuales;<\/li>\n\n\n\n<li>S\u00edncope de causa no esclarecida;<\/li>\n\n\n\n<li>Hipertensi\u00f3n arterial confirmada;<\/li>\n\n\n\n<li>Enfermedad de Kawasaki con compromiso coronario;<\/li>\n<\/ol>\n\n\n\n<h4 class=\"wp-block-heading\" id=\"mcetoc_1irs855bu1g\"><strong>&#8211; Antecedentes familiares de riesgo:<\/strong><\/h4>\n\n\n\n<ol class=\"wp-block-list\">\n<li>Muerte s\u00fabita en familiares &lt;50 a\u00f1os;<\/li>\n\n\n\n<li>Miocardiopat\u00edas hereditarias;<\/li>\n\n\n\n<li>Canalopat\u00edas (S\u00edndrome de QT largo, Brugada, etc.);<\/li>\n<\/ol>\n\n\n\n<h4 class=\"wp-block-heading\" id=\"mcetoc_1irs855bu1h\"><strong>&#8211; Hallazgos cl\u00ednicos actuales:<\/strong><\/h4>\n\n\n\n<ol class=\"wp-block-list\">\n<li>Soplo card\u00edaco no evaluado previamente o nuevo;<\/li>\n\n\n\n<li>Cianosis, disnea o fatiga desproporcionada con el esfuerzo;<\/li>\n\n\n\n<li>Hipoxemia inexplicada o saturaci\u00f3n &lt;95%;<\/li>\n\n\n\n<li>Presi\u00f3n arterial anormal en controles prequir\u00fargicos;<\/li>\n<\/ol>\n\n\n\n<h4 class=\"wp-block-heading\" id=\"mcetoc_1irs855bu1i\"><strong>&#8211; Pacientes con enfermedades cr\u00f3nicas asociadas:&nbsp;<\/strong><\/h4>\n\n\n\n<ol class=\"wp-block-list\">\n<li>S\u00edndrome de Down;<\/li>\n\n\n\n<li>Trastornos neuromusculares;<\/li>\n\n\n\n<li>Enfermedades renales cr\u00f3nicas;\u00a0<\/li>\n\n\n\n<li>Trastornos endocrinos con repercusi\u00f3n cardiovascular.<\/li>\n<\/ol>\n\n\n\n<h4 class=\"wp-block-heading\" id=\"mcetoc_1irs855bu1j\"><strong>&#8211; Estudios complementarios previos alterados:<\/strong><\/h4>\n\n\n\n<ol class=\"wp-block-list\">\n<li>ECG anormal o no interpretable;<\/li>\n\n\n\n<li>\u00a0Rx de t\u00f3rax con cardiomegalia;<\/li>\n<\/ol>\n\n\n\n<blockquote class=\"wp-block-quote is-layout-flow wp-block-quote-is-layout-flow\">\n<p><strong>Todo paciente menor de 1 a\u00f1o deber\u00e1 contar con un electrocardiograma de base.<\/strong><\/p>\n<\/blockquote>\n\n\n\n<h4 class=\"wp-block-heading\" id=\"mcetoc_1irs855bu1l\"><strong>&#8211; No se indica ECG ni interconsulta cardiol\u00f3gica en:<\/strong><\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Ni\u00f1os sanos, sin antecedentes ni hallazgos cl\u00ednicos sugestivos;<\/li>\n\n\n\n<li>Procedimientos de bajo riesgo anest\u00e9sico (como cirug\u00eda menor ambulatoria).<\/li>\n\n\n\n<li>Soplos funcionales ya evaluados y documentados previamente como inocentes.<\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\" id=\"mcetoc_1irs855bu1m\"><strong>4.- Bibliograf\u00eda respaldatoria&nbsp;<\/strong><\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Sociedad Argentina de Pediatr\u00eda (SAP). Recomendaciones para la evaluaci\u00f3n prequir\u00fargica pedi\u00e1trica. SAP, 2021.\u00a0<\/li>\n\n\n\n<li>American Academy of Pediatrics (AAP). Preoperative Assessment in Children. Pediatrics. 2015.\u00a0<\/li>\n\n\n\n<li>American Heart Association (AHA). Cardiovascular evaluation and management of pediatric patients undergoing noncardiac surgery. Circulation. 2009.\u00a0<\/li>\n\n\n\n<li>Asociaci\u00f3n de Anestesia, Analgesia y Reanimaci\u00f3n de Buenos Aires. Recomendaciones preanest\u00e9sicas pedi\u00e1tricas. AAA, 2022<\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"<p>Este es un documento gu\u00eda elaborado por el Servicio de Cardiolog\u00eda del Hospital Materno Infantil San Roque y emitido con [&hellip;]<\/p>\n","protected":false},"author":4,"featured_media":0,"comment_status":"closed","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"categories":[15],"tags":[],"class_list":["post-1981","post","type-post","status-publish","format-standard","hentry","category-repositorio-digital"],"_links":{"self":[{"href":"https:\/\/hospitalsanroque.gob.ar\/index.php\/wp-json\/wp\/v2\/posts\/1981","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/hospitalsanroque.gob.ar\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/hospitalsanroque.gob.ar\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/hospitalsanroque.gob.ar\/index.php\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/hospitalsanroque.gob.ar\/index.php\/wp-json\/wp\/v2\/comments?post=1981"}],"version-history":[{"count":1,"href":"https:\/\/hospitalsanroque.gob.ar\/index.php\/wp-json\/wp\/v2\/posts\/1981\/revisions"}],"predecessor-version":[{"id":1982,"href":"https:\/\/hospitalsanroque.gob.ar\/index.php\/wp-json\/wp\/v2\/posts\/1981\/revisions\/1982"}],"wp:attachment":[{"href":"https:\/\/hospitalsanroque.gob.ar\/index.php\/wp-json\/wp\/v2\/media?parent=1981"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/hospitalsanroque.gob.ar\/index.php\/wp-json\/wp\/v2\/categories?post=1981"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/hospitalsanroque.gob.ar\/index.php\/wp-json\/wp\/v2\/tags?post=1981"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}