[testimonial]To know more about cardiac insufficiency[/testimonial]

 

 

 

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[tab title="Understanding cardiac insufficiency"]

What is cardiac insufficiency?

The term cardiac insufficiency means heart failure, which happens when the heart is unable to perform its basic function to pump blood (loaded with oxygen and nutrients) to all the cells in the body so they may function normally.

People who suffer from cardiac insufficiency do not receive an adequate supply of oxygen and nutrients and thus feel weakness, fatigue or shortness of breath. Daily activities like walking, climbing stairs, carrying packages and gardening can become really difficult.

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What are the causes of cardiac insufficiency?

When someone experiences heart failure, he probably has or has had one of the following causes without even being aware of it; some affect the heart directly and others alter its function without causing damage.

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Among the following are:

Coronary artery disease

When cholesterol and fats are deposited in the arteries, they form plaques of fat which narrow the artery, limiting blood flow to the heart muscle. This damages the muscle and cardiac tissue which then has less force to do its job.

Prior heart attack (myocardial infarction)

A myocardial infarction occurs when one of the coronary arteries is obstructed. The loss of oxygen and nutrients damages the heart muscle which begins to die.

Arterial hypertension

Decompensated arterial pressure doubles the risk for a person to have a heart attack. When the pressure in blood vessels is elevated, the heart must pump harder to maintain blood circulation, affecting its function, and in time the chamber becomes larger and weaker.

Abnormal heart valves

Heart valve problems may be the result of various causes like infections or congenital heart defects. When the valves do not open or close completely at each heartbeat, the heart muscle must pump more strongly to maintain blood circulation, and if it is not repaired in time, the heart will fail.

Heart muscle disease (cardiomyopathy) or inflammation (myocarditis)

Any damage to the heart muscle, whether from toxic drug use, alcohol, viral infections or unknown reasons, increases the risk of cardiac insufficiency.

Congenital heart problems

If the heart and its chambers are not formed correctly, the heart´s function may be affected.

Severe pulmonary disease

When the lungs do not work as they should, the heart finds an obstacle in its function.

Diabetes

Diabetes increases the risk of heart attack in various ways. Diabetics tend to be obese, hyper tense with high cholesterol, all of which increases the risk of damage to the heart. The role of the doctor is to establish in each patient the cause or causes responsible for his condition and at the same time to explain what is happening in his particular case and how to resolve the problem, either with medicine or special treatment.

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Who is affected?

Cardiac insufficiency affects people of all ages, from children to adolescents to adults and the elderly. However, it is most commonly found in the elderly.

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How many types of cardiac insufficiency are there?

SHF Systolic heart failure
There is reduced contractility of the heart.

DHF Diastolic heart failure
Abnormal ventricle relaxation.

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[tab title="How to diagnose cardiac insufficiency"]

How to diagnose heart failure?

To make a diagnosis, your doctor will want to make a complete physical exam and ask you about your medical history and symptoms. Be honest and do not be afraid of looking bad. For example, if you smoke (or a family member does), eat lots of fast food and never exercise, tell this to your doctor. He cannot make an accurate diagnosis without your collaboration. Think about working together as a team to reach success.

Moreover, you must have blood and urine tests (to verify that the liver and kidneys have not been affected by cardiac insufficiency), x-rays of the thorax (to determine whether the heart has increased in size and whether there is pulmonary congestion), a resting electrocardiogram (to register the electric activity of the heart) and to ascertain if the patient has suffered a myocardial infarction, whether the left ventricle has thickened or the cardiac rhythm is abnormal, Doppler echocardiogram (ultrasound of the heart which helps the doctor detect the thickness of the heart and how it pumps blood), echocardiogram of stress, exercise tolerance test (to monitor heart activity during exercise), a Holter monitor for 24 hours, studies of nuclear medicine and other more complex diagnostic methods like coronariography, heart catheterization, and biopsy of the heart muscle when necessary.

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How is it treated?

Treatment is complex and depends on the cause and how advanced the disease at the moment of diagnosis. In general the following methods exist:

1. Non-pharmacological measures
2. Pharmacological measures
3. Special therapeutic measures

Non-pharmacological measures

These are related to changes in the life-style of the patient. You or your loved one must change your daily routine.

• Stop smoking
• Reduce your weight.
• Avoid alcohol
• Avoid caffeine
• Don´t consume prohibited drugs (ex. Cocaine)
• Eat fat free foods with little salt and many vegetables
• Exercise (depends on each patient), under the supervision of the cardiologist

Naturally it is easier to say this than do it. Our lives are very busy without having to cope with these restrictions and responsibilities. However, working with these changes to your routine, one at a time, can make a real difference.

Pharmacological measures

Oral medications, patches, inhalations, injections under the skin or in veins. The list is very extensive and helps to:

• Improve general circulation by increasing the force of the heart contractions or expanding the blood vessels
• Reduce the amount of water and sodium in the organism to diminish volume overload
• Stop or slow the progress of the disease by improving the quality of life

Special therapeutic measures

Together with the above measures, it is possible to stop the progression of the disease and improve the quality of life of the patients. In general, they are costly and require specialized equipment, highly qualified doctors and a multidisciplinary team (doctors, nurses, social worker, technicians in cardiology, nutritionists, physiatrists, psychologists, epidemiologists, etc.), to implement them. Some examples include coronary angioplasties (dilations of the heart arteries when they are severely obstructed), heart surgery of different types including heart by-pass surgery, replacement or repair of heart valves, correction of congenital heart diseases, repair of damage of the main arteries or even the heart itself, pacemaker insertion and other numerous techniques and supportive devices to keep the patients alive. Success of treatment depends on the degree of commitment of the patient to follow through on the treatment, whether it requires changes in life style, medications or surgery.

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What must I watch out for?

Tell your doctor if you:

• Gain weight on a daily basis
• See swelling in your feet, ankles or other parts of your body
• Have difficulty breathing when doing simple activities
• Can no longer do something you could do before
• Have a cold
• Have fever
• Have chest pain

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[tab title="Signs and symptoms of cardiac insufficiency"]

When should I suspect that I have cardiac insufficiency?

The symptoms that a person feels and the signs that the doctor sees when he examines a patient vary according to the types and causes of cardiac insufficiency. In general, there are classical symptoms which can be found in other illnesses, but when they are present, must make us suspect that the heart might be failing.

If you experience:

• Dyspnea: difficulty breathing while exercising, doing daily activities or resting
• Edema of the lower limbs: the feet swell especially in the afternoon
• Nocturia: : you get up to urinate several times at night
• Paroxysmal nocturnal dyspnea: you get up several times at night for shortness of breath and have to sit up or get up to alleviate the problem
• Palpitations: you feel that the heart beats are rapid and irregular
• Loss of appetite, nausea: you feel full or sick to your stomach
• Confusion or difficulty thinking: yyou experience memory loss or disorientation
• Easy fatigue: you tire easily doing activities that you used to do easily
• Cyanosis: your lips, hands or mouth turn blue or purple
• Cough or feel unsettled
• Coldness or paleness of the limbs
• Chest pain or pressure: present when in repose or making an effort

“You must consult with your doctor for a diagnosis as quickly as possible.”

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When will it start?

When it appears is variable and depends on the types and causes of cardiac insufficiency. For example, in the case of an extensive myocardial infarction, the cardiac insufficiency can start in hours or weeks, but if the cause is inadequately-controlled arterial hypertension, then it can take months or years to appear. It is most important not to wait until the patient feels bad to get medical help, because then it may be too late. The cardiologist can make a diagnosis in time using a Doppler electrocardiogram (special ultrasound to evaluate the heart) long before the symptoms appear.

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Can it be cured?

Cardiac insufficiency is a serious condition and usually cannot be completely cured. We deliberately use the phrase “live with cardiac insufficiency” because really the patient with cardiac insufficiency learns to do that. In the majority of cases, cardiac insufficiency can be controlled with medication and changes in habits like diet and exercise. The help of family and friends is vital. These changes usually are the key to a full life.

With the continuing education of the general population and of patients in particular, with early medical consultation, especially with cardiologists that have methods of rapid and timely diagnosis, with modern and effective medicines and with the awareness of health authorities, it is possible to approach the management of cardiac insufficiency in an adequate manner.

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[tab title="Diet for cardiac insufficiency"]

Upon hearing that we have heart disease, the first thought is: what can we eat now? The answer we give ourselves is possibly: nothing!

But it is not like that. Despite the disease, we can enjoy the majority of foods, if we follow these basic recommendations.

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What is the goal of nutritional assistance?

To feed ourselves in the best way, causing the least stress possible to the heart, reducing and preventing edema.

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What should our diet be?

Follow these rules:

• 5 or 6 meals a day
• Frequent small meals to decrease the workload of the heart
• Breakfast, snack, lunch, snack, dinner and snack (optional)
• Low fat diet
• Choose foods that have been broiled, boiled, baked or barbecued. NOT FRIED.
• Low colesterol diet
• Avoid food products made from animal fats like:
• Processed meats: bologna, sausage, pepperoni, pork sausage, salami, ham, pate
• Fatty meats: pork cracklings, pork chops, beef and pork ribs
• Yellow or mature cheeses: Cheddar, Swiss, Gouda, Edam, Monterrico, American

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What about salt?

We have to be careful about two types of salt:

• The salt we add to food (table salt)
• The salt contained in the food itself

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How much table salt can we use?

Do not add salt during food preparation

Put ¼ teaspoon of salt in a little bag and add this amount to the food prepared during a whole day

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What about the salt contained in the food itself?

We must choose the products we consume with greater care and buy those with the least amount of salt, avoiding the salty ones.

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What foods should we consume?

• Fruit and fruit juices
• Fresh vegetables
• Meat and fresh fish
• White cheese (Turrialba, Montino, Tico)
• Dry cereals, saltless crackers and low sodium breads
• Natural sauces (prepared at home using fresh ingredients without adding salt)
• Natural condiments (sweet pepper, onion, basil, oregano, garlic, thyme, etc.)
• Homemade soup (without salt)

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Which foods should we avoid?

• Processed meats
• Smoked, processed or cured meats and fish
• Processed cheese
• Canned goods
• Pre-packaged foods
• Extract of meat, soup cubes, packaged mixtures for sauces, herbal salts like garlic salt
• Instant soups
• Prepared salad dressings and commercial sauces

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Should we exercise?

• Only if the doctor tells us to
• Doing any physical activity depends on the seriousness and state of the disease

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Which foods must we avoid if we are taking anti-coagulants?

When you are being treated with anti-coagulants like warfarin (a type of medicine that prevents the formation of clots in the blood), you must restrict and sometimes avoid all foods rich in vitamin K, as these reduce the effectiveness of that medicine. For example:

• Leafy green foods like: spinach, cabbage, broccoli, dark green lettuce, turnip greens alfalfa, parsley
• Some drinks like black and green teas
• Some legumes like chick peas and lentils
• Some cooking oils like soy and canola oils
• Meats: beef and liver have an average content of vitamin K. It is preferable to choose white meats like chicken and fish

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What should I do if I experience kidney damage?

Kidney disease is very complex and during its treatment it is important to control the amount and the quality of protein (chicken, fish, meat, eggs) that we consume. It all depends on whether or not we are on dialysis.

For this reason, you must follow the directions and specific recommendations that the doctor and the nutritionist make in consultation.

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And remember:

• No smoking
• Avoid alcoholic beverages
• Take your medicine regularly according to medical indication.

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[tab title="Physical activity with cardiac insufficiency"]

Can I do physical activity if I have cardiac insufficiency?

For most people with cardiac insufficiency, physical activity does not entail greater risk. However, before initiating an exercise program or increasing your level of activity, you should consult with your doctor about how, when and which exercises you can do.

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What are the benefits of doing physical activity?

Keeping active has great benefits: you will feel better, your symptoms of cardiac insufficiency will be reduced, your heart function will be improved, you will be able to return to your daily activities more quickly and you will feel less stress and anxiety.

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What precautions must I take in doing physical activity?

Avoid doing increased physical activity if you feel shortness of breath when resting or feel exhausted, if you have chest pain, fever or infection, if you observe swelling in your feet or are going through a period of important changes in your medication.

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Which physical activities are recommended for patients with cardiac insufficiency?

After your medical evaluation, it is recommended to:

• Swim
• Walk
• Bicycle

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Recommendations for the patient of cardiac insufficiency when he does physical activities

• Use appropriate clothing
• Wear comfortable shoes
• Avoid extreme climatic conditions (intense cold or heat)
• Avoid eating one hour before exercising
• Avoid strenuous physical exercise
• If you feel any symptom of discomfort whatsoever, you must stop the activity and consult your doctor.

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[tab title="Guide for having your blood pressure checked at home with adjustable automatic equipment for your arm"]

Important considerations before taking your blood pressure

1. You should rest for 5 minutes before checking your blood pressure
2. Preferably you feel relaxed and are comfortably seated.
3. Your feet should be flat on the floor, legs uncrossed.
4. You must sit with your back straight
5. Relax your forearm and lean it on a table or pillow.
6. The cuff must be at heart level.
7. Be still without talking as this might alter the results.

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Proper cleaning

Clean the monitor with a soft dry cloth. Don´t try to clean the cuff.

Step 1
Connect the end of the tube to the main unit.

Step 2
Roll up the sleeve of your shirt, blouse, or sweater, being careful not to exert pressure on the arm.

Step 3
Unroll the cuff, leaving a circular space in which to insert your arm.

Step 4
Place the cuff on the upper arm in such a way that the arrow and the air tube are on the inside of the arm.

Step 5
Wrap the cuff snugly around your arm without pulling it too tight.

Step 6
Press the START/STOP button. All the symbols appear on the screen. The cuff inflates automatically. You must remain still until you observe the result on the screen.

When you finish measuring, the cuff deflates completely. The blood pressure and pulse appear.

Step 7
Press the START/STOP button to turn off the monitor. It will turn off automatically after five minutes.

Step 8
Record the results, including date and time, in the blood pressure record sheet which you have been given or in a notebook.

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Information

pic@clinicabiblica.com

Telephone: 2522-1000 y 8000-911-800

 

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1- Costa Rica, 2 - Costa Rica, 3 - Panama-Honduras, 4 - Panama, 5 - Panama, 6 - Dominican Republic, 7 - Dominican Republic, 8 - Colombia.

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[acc title="Heart Failure Symposium 2015" style="style3" ]

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[testimonial]The information in the clinical health record is confidential, in accordance with the regulations in force in the country, and we comply with these regulations in the application of the protocols, regulations and policies of the Hospital.[/testimonial]

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[tab title="Medical records"]

Patient records subsidiary

This is a subsidiary of the Medical Management Department (Dirección Médica), which specializes in the management of the information system of health services of the Clínica Bíblica Hospital. Among our responsibilities are the following:

• Custody of the clinical information of our patients (clinical health record)
• Elaboration of health statistics
• Supervision of the quality of medical records
• Making available clinical health records to guarantee the continuity of attention and evolution of our patients

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Committee of clinical health records

This is a technical entity charged with organizing, according to national and institutional norms, the regulations about procedures, use, custody, conservation and conformation of clinical health records.

It is made up of the following services: Medical Management Department, Nursing Department, Legal Services, Medical Records, Admissions, and Hospital Unit of Quality Care.

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Confidentiality

A clinical health record is made for each patient who receives attention in our institution to guarantee the integration and continuity of attention. The health record is a legal medical document, which at all times is monitored to control the quality of the clinical information and protection of confidentiality given to users.

The information contained in the clinical health record is confidential, as required by the regulations in force in the country and we ensure the fulfillment of this confidentiality with the application of protocols, regulations and policies in the Hospital.

For this reason at the Clínica Bíblica Hospital and according to Articles 189,190 and 191 of the General Regulations for Hospitals of the Republic of Costa Rica, it is strictly forbidden to facilitate clinical health records to third parties, except with written authorization of the patient, duly authenticated and complying with the requirements of the stated law.

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[tab title="Certificates"]

Certificates of birth, death, epicrisis, and others

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Epicrisis

An epicrisis is a clinical summary of a hospitalization or an outpatient visit of the patient. This summary might include:

• Reason for hospitalization or consultation
• Diagnosis for admission or discharge
• If a surgical procedure took place
• Medical treatments
• Condition of hospital discharge

To process an epicrisis, a person can do the following:

• Call our central telephone exchange directly at 2522-1000 to request the process.
• Make your request by electronic mail at contraloriadeservicioalcliente@clinicabiblica.com. It is necessary to include a copy of the patient´s identification document).
• If you come personally, please bring the patient´s document of identification and go to the reception area in the south lobby of the Clínica Bíblica Hospital.
• Complete the form requesting medical documents (Formulario de Solicitud de Documentos Médicos: FO.RM-012), specifying the date of the medical consultation and hospitalization.
• The process takes 8 business days and you will be notified by telephone when it can be collected.

In case the certificate is requested or collected by a third party, he must provide documents of identification and authorization in writing by the patient, duly authenticated by a lawyer and in compliance with the regulations established in the General Regulations for Hospitals of the Republic of Costa Ricain Articles 189, 190 and 191.

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Birth Certificate

The birth certificate is an official document of the birth of an individual, which is signed by the interested parties in front of a Registry assistant of the Civil Registry. To request a birth certificate:

• The father or mother must be present to sign a birth certificate within eight days after the birth.
• Either parent must bring an identification document (cedula, passport or resident cedula)
• Verify that all the vital data are correct.
• The father or mother shall verify that all data specified in the vital statistics form are correct.
• If the mother is single, married (when the birth takes place within the 365 days after the civil ceremony), in a domestic partnership, legally separated or divorced, and the baby is born after the 300 days of judicial separation or divorce, both parents must be present to sign the birth certificate.
• In cases in which the parents were underage at the time of the birth, they must be accompanied by an adult with a degree of kinship.
• If the parents are foreigners or were married abroad, the father and mother must be present to register the birth certificate at the respective office of the Hospital.
• When the birth occurs after the 365 day period following the wedding, one of the parents must sign the birth certificate.
• Each week the Department of Medical Records sends the certificates that have been signed by the parents to the Civil Registry for due process of inscription.

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Certification of Birth

The certification of birth is an official document that certifies the birth of an individual. Certifications are needed for different purposes, by different institutions like: embassies, migratory offices for their respective procedures, education centers and special requests of the Civil Registry.

To request a Certification of Birth, the person must:

• Present himself personally at the reception area of Medical Records with his identification document.
• Complete the form requesting medical documents (Formulario de Solicitud de Documentos Médicos: FO.RM-012), specifying the date of birth and the complete name of the mother.

*The process takes 8 business days and you will be notified by telephone when the document can be collected. If it is solicited by a third party, it will be necessary to present identification documents and authorization in writing, duly authenticated by an attorney, and to comply with the requirements established by law in the General Regulations for Hospitals of the Republic of Costa Ricain Articles 189, 190 and 191.

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Certification of Death

The certification of death is an official document that certifies the death of an individual. Certifications are solicited for different purposes, by different institutions like: embassies, banking institutions, life insurance companies, attorneys to process legal procedures and special requests of the Civil Registry.

To request a certification of death the person must:

• Present himself personally with his identification document. (The interested party must have some degree of kinship with the deceased).
• Fill out a form in writing.
• Present a certification from the Civil Registry stating his kinship (Certification of Birth or Certification of Marriage) at the reception of Medical Records.
• • Complete the form requesting medical documenta (Formulario de Solicitud de Documentos Médicos: FO.RM-012).

*The process takes 8 business days and you will be notified by telephone when the document can be collected.

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Certification of Declaration of Death

This is the official document that declares the death of an individual at the Clínica Bíblica Hospital and is signed by the interested party, the treating physician and the Registry assistant of the Civil Registry.

To receive the Certification of the Declaration of Death the person must:

• Present himself personally with his identification document. (The interested party must have some degree of kinship with the deceased).
• Verify that all the vital data in the Certification of the Declaration of Death are correct.
• If the data on the Certification of the Declaration of Death are correct, the interested party must sign the document which he receives.
• Each week the Department of Medical Records sends the certificates to the Civil Registry for due process of inscription.

For more information, call (506) 2522-1000. Extensions 7812 and 7813.

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[testimonial]All payment for hospitalization must first be verified in the statement of the Patient Accounting Department (Departamento de Cuentas a Pacientes) and then cancelled in the agency of the Banco de Costa Rica located on the main floor of the Hospital.[/testimonial]

Payment may be made in cash or by cashier´s check in colones or in dollars. Payment may also be made by credit or debit card, traveler´s checks (preauthorized and signed in the presence of the cashier) and, in all cases, the person who is making the payment must present an identifying document.

If you have been covered by a policy (insurance company, business or employee solidarity association), you must come to the agency of the Banco de Costa Rica before leaving the hospital to sign the hospitalization bill and the respective documents and to pay the amount not covered by the insurance, business or association policies.

It is also possible to make bank transfers and in the case of a transfer a deposit slip or copy of the transaction must be presented to the Patient Accounting Department.

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Payment forms

For added security, you may complete all your payment formalities within the Hospital with your credit card.

• If you prefer, you may pay by check from the Banco de Costa Rica or with a cashier´s check from any other bank.
• If you wish to make a transfer to one of the Hospital accounts, you must send the deposit receipt by fax or electronic mail to the Admissions Department at least one day in advance of the procedure to be made.

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Insurance Companies

Policy	Services
AETNA INTERNACIONAL	Ambulatory
ALLIANZ GLOBAL ASSISTANCE	Hospitalization
ALLIANZ WORLDWIDE CARE	Ambulatory and Hospitalization
ASSURED ASSISTANCE INC (RCB INSURANCE)	Hospitalization
AXA ASSISTANCE	Ambulatory and Hospitalization
BEST DOCTORS INSURANCE HOLDINGS, LLC	Ambulatory and Hospitalization
BEST MERIDIAN INSURANCE COMPANY	Ambulatory and Hospitalization
BLUE CROSS BLUE SHIELD	Hospitalization
BLUECROSS BLUESHIELD COSTA RICA - (TRIPLE-S BLUE INC)	Ambulatory and Hospitalization
BUPA IHI DENMARK	Hospitalization
BUPA INTERNATIONAL	Ambulatory and Hospitalization
CANASSISTANCE	Hospitalization
CEGA GROUP	Ambulatory and Hospitalization
CIGNA INTERNATIONAL	Ambulatory and Hospitalization
CMN GLOBAL INC Compañias GBG, GMMI, Generalli, GMS, Argus, Sagicor are part of CMN Global	Ambulatory and Hospitalization
CULTURAL INSURANCE SERVICES INTERNATIONAL	Ambulatory and Hospitalization
EUROCROSS INTERNACIONAL	Hospitalization
EUROP ASSISTANCE	Ambulatory and Hospitalization
GOUDA	Ambulatory and Hospitalization
HENNER - GMC	Ambulatory and Hospitalization
HTH WORLWIDE INSURANCE SERVICES/GEOBLUE	Ambulatory and Hospitalization
INTERMUTUELLES	Hospitalization
INTERNATIONAL MEDICAL GROUP (IMG)	Hospitalization
INTERNATIONAL SOS (SOS SEGUROS Y REASEGUROS)	Ambulatory and Hospitalization
INTERNATIONAL SOS (TRICARE)	Ambulatory and Hospitalization
MAPFRE	Ambulatory and Hospitalization
METLIFE INSURANCE	Ambulatory and Hospitalization
MORGAN WHITE	Ambulatory and Hospitalization
PAN AMERICAN LIFE INSURANCE DE COSTA RICA, S.A.	Ambulatory and Hospitalization
QUALITY HEALTH MANAGEMENT (QHM)	Ambulatory and Hospitalization
RALEIGH INTERNATIONAL	Ambulatory and Hospitalization
SEVEN CORNERS	Hospitalization
UNITED HEALTH CARE GLOBAL / IEES	Ambulatory and Hospitalization
UNITED HEALTH CARE GLOBAL SOLUTIONS	Ambulatory and Hospitalization
UNIVERSAL ASSISTANCE	Ambulatory and Hospitalization
VUMI GROUP	Ambulatory and Hospitalization
WTP ASSIST (World Travel Protection Canada Inc.)	Ambulatory and Hospitalization

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Intermediary

Policy	Services
ASA (ASSISTANCE SERVICES OF THE AMERICAS)	Ambulatory and Hospitalization
EUROP ASSISTANCE ESTEBAN VILLEGAS	Ambulatory and Hospitalization
MED-X	Ambulatory and Hospitalization
ON CALL INTERNATIONAL	Ambulatory and Hospitalization
REDBRIDGE	Ambulatory and Hospitalization
SEGURO OCCIDENTE BRENNTAG	Ambulatory and Hospitalization

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Payments by transfer

You may make the initial payment by electronic transfer (SINPE) or deposit directly into the following accounts.

Once the deposit has been made, you must send us the deposit receipt by fax to 2522-1252 or by e-mail to: admission@clinicabiblica.com.

Remember to indicate the name of the patient in the observation section of the deposit receipt.

If you prefer, you may pay by check from the Banco de Costa Rica or by cashier´s check from any other bank in the name of ASEMECO.

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Bank Accounts in colones

Bank	Number	Customer Account
BAC San José	900-198-045	102-0000-900198045-1
DAVIVIENDA Cuenta Maestra	101-442	104-00-101442-020114
Banco de Costa Rica	001-0100766-1	15201001010076610

Bank Accounts in dollars

Bank	Number	Customer Account
BAC San José	900-250-549	102-0000-900250549-1
DAVIVIENDA	101-442	104-00-101442-020120
Banco de Costa Rica	178-807-8	152-010010-178807-81

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