Paulo Roberto Schvartzman

Normal values of echocardiographic measurements. A population-based study.

OBJECTIVE To describe echocardiographic measurements and left ventricular mass in a population sample of healthy adults inhabitants of the urban region of Porto Alegre. METHODS An analytical, observational, population-based, cross-sectional study was done. Through a multi-stage probability sample, 114 individuals were selected to be submitted to a M-mode and two-dimensional echocardiogram with color Doppler. The analyses were restricted to healthy participants. Echocardiographic measurements were described by mean, standard deviation, 95 percentile and 95% confidence limits. RESULTS A total of 100 healthy participants, with several characteristics similar to those from the original population, had a complete and reliable echocardiographic examination. The measurements of aorta, left atrium, interventricular septum, left ventricle in systole and diastole, left posterior wall and left ventricular mass, adjusted or not for body surface area or height, were significantly higher in males. The right ventricle size was similar among the genders. Several echocardiographic measurements were within standard normal limits. Interventricular septum, left posterior wall and left ventricular mass, adjusted or not for anthropometric measurements, and aortic dimensions had lower mean and range than the reference limits. CONCLUSION The means and estimates of distribution for the measurements of interventricular septum, left posterior wall and left ventricular mass found in this survey were lower than those indicated by the international literature and accepted as normal limits.

Divertículo ventricular congênito associado à taquicardia ventricular

Congenital ventricular diverticula are rare. Clinically, they may be asymptomatic or cause systemic embolization, heart failure, valvular regurgitation, ventricular rupture, ventricular arrhythmia, or sudden death. We report the case of a 56-year-old woman with sustained ventricular tachycardia, who, during investigation, was diagnosed with a diverticulum in the inferobasal portion of the left ventricle. The clinical characteristics and treatment of this rare disease are discussed.

Uso do ecocardiograma transesofágico na cardioversão de fibrilação atrial

A fibrilacao atrial (FA) e a taquiarritmia mais comumente encontrada na pratica clinica, cuja prevalencia aumenta dramaticamente com a idade 1. A prevalencia de FA no estudo de Framingham e inferior a 1% na 6° decada de vida, porem pode atingir 9% em octogenarios 1. A FA e caracterizada por atividade mecânica e eletrica irregular e desorganizada dos atrios, podendo resultar em alteracao na capacidade funcional e aumento no risco de insuficiencia cardiaca, eventos tromboembolicos e morte 1,2. O objetivo do tratamento da FA e manter o ritmo sinusal, controlar a frequencia cardiaca e prevenir o tromboembolismo. O paciente, permanecendo em ritmo sinusal, apresenta beneficios, tais como, eliminacao dos sintomas da arritmia, melhora do estado hemodinâmico e diminuicao do risco do tromboembolismo 1,2, o que torna importante, sempre que possivel, reverter o ritmo para sinusal, sempre que o paciente se apresentar com FA.