Síndrome del escaparate

síndrome del escaparate

El síndrome del escaparate o Claudicación es como se conoce popularmente a la Isquemia Crónica de Miembros Inferiores, cuyo principal síntoma es un dolor en las piernas que obliga al paciente a detenerse cada cierto tiempo y que en la actualidad afecta a un 8% de los Españoles mayores de 50 años.

 

En cuanto a la necesidad de detenerse cada cierto tiempo al caminar, en las primeras fases, se produce tras andar grandes distancias.
Pero con el tiempo aumentan las arterias obstruídas y progresivamente esas distancias se van acortando hasta que llega un momento en el que el paciente siente dolor incluso en reposo.
A partir de ahí el enfermo puede desarrollar lesiones isquémicas en forma de gangrena que pueden llevar, en casos extremos, a aconsejar la amputación de la extremidad.

 

Es un problema relacionado con el flujo de sangre dentro de las arterias. Las arterias llevan sangre del corazón a los músculos y órganos del cuerpo. Cuando  tiene lesiones en las arterias estas se angostan o se bloquean. La causa más común es la acumulación de depósitos de grasa. Esto se llama aterosclerosis. La queja más común en las personas que tienen EAP es la claudicación.

 

 

¿Qué es la claudicación?

 

La claudicación intermitente, se trata de un dolor en los grupos musculares distales debido a una obstrucción arterial crónica, generalmente en miembros inferiores, y que se desencadena por el ejercicio y desaparece en reposo.  Obliga a la persona que lo padece a detenerse durante la marcha, por lo que se le da el nombre de “síndrome o enfermedad del escaparate”

 

Síntomas

 

Dolores.

Calambres.

Entumecimiento de la zona.

Sensación de fatiga muscular.

Si el paciente también nota dolor cuando está en reposo, significa que la obstrucción de las arterias es mayor que si sólo duele mientras se hace ejercicio.

También suelen aparecer engrosamiento de las uñas de los pies y hormigueos en las áreas afectadas, así como una mayor dificultad para la cicatrización de las heridas.

 

 

¿ Cómo la podemos tratar?

 

En la EAP crónica como tratamiento preventivo se indica el masaje circulatorio superficial por producir una vasodilatación refleja en las zonas afectadas.
El efecto de las maniobras de masaje va a provocar un estímulo en el flujo sanguíneo arterial y una aceleración de la circulación que se traduce a su vez, en un rubor en la zona.

Este rubor se va a producir por vasodilatación de los vasos periféricos y será más intenso cuanto más constante y profundo sea el estímulo aplicado.
Esta vasodilatación va a ser debida en gran medida a la liberación de acetilcolina, histamina y sustancias histaminoides.

 

Con el aumento del flujo arterial se produce así mismo un aumento de 0xigeno y de sustancias nutritivas aumentando con ello el metabolismo local. Esto provocará también una mejora del estado trófico de la piel y los tejidos subyacentes.
Aunque el efecto que el masaje produce sobre la circulación arterial no es tan directo como el que produce sobre la venosa, ya que la mayor parte de las arterias están situadas en planos bastante profundos, sí se da una especie de estimulación “de rebote”, al tratar de forma profunda las masas musculares.

Esto puede ser observado claramente en los individuos que sufren claudicación intermitente; tras unas sesiones de masaje mejora el color de la piel y la temperatura y desaparece en gran medida, la claudicación; esto demuestra el efecto beneficioso que el masaje provoca sobre las arterias, mejorando además la circulación colateral de la zona.

 

Consejos

 

  • Procurar evitar el frío y el uso excesivo de miembros inferiores.
  • Elevar la cabecera de la cama 25-30 cm.
  • Cambio en los hábitos tóxicos: Dejar de fumar, no consumir alcohol, etc.
  • Estudio de los pies: conservación de la sensibilidad protectora, presencia de cambios tróficos en la dermis, la masa muscular, etc.
  • Desde el punto de vista biomecánico, procurar que el apoyo en el suelo sea equilibrado y sobre el material adecuado para amortiguar las presiones durante la marcha y proteger las estructuras del pie.

 

Consejos sobre el calzado

 

  • Consejos sobre el calzado : LLevar un número mayor del usado permitiendo en su interior el uso de la ortesis, punta de horma ancha, suela cómoda y flexible, a poder ser de cuero transpirable, y sin tacón alto.
  • Los calcetines o medias adecuados ( lino o algodón (transpirables), o de lana sin gomas, elásticos o costuras)
  • No caminar descalzo, sobre todo si hay alteraciones sobre la sensibilidad y procurar la protección de miembro inferior frente a posibles traumatismos, quemaduras, infecciones, etc.
  • La visita periódica al podólogo para la vigilancia de los pies y de uñas encarnadas, hiperqueratosis (callosidades), Hallux Valgus (“juanetes”), ulceraciones, erupciones o ampollas en piernas o pies

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