Samira Morhy Borges Leal

Left Atrial Myxoma. Three-Dimensional Echocardiographic Assessment

The patient was a 70-year-old female with antecedents of diabetes mellitus and hypertension, being followed up in the outpatient care clinic due to chronic anemia after corrective surgery for angiodysplasia of the proximal jejunum, in whom an image suggestive of left atrial myxoma was found on routine transthoracic echocardiography. Then multiplanar transesophageal echocardiography and 3-dimensional echocardiography were performed, showing the latter better anatomical details of the tumor. The patient underwent exeresis of the mass with anatomicopathological confirmation of the tumor. Three-dimensional echocardiography proved to be a technique that can provide additional contributions to the diagnostic investigation of structural heart diseases.

Lung neoplasm mimicking an acute lateral myocardial infarction.

Involvement of the heart and pericardium by cancer is not uncommon, with metastases being more frequent than primary cardiac neoplasms. We present a case of a metastatic lung cancer for which the primary manifestation was chest pain mimicking an acute myocardial infarction.

Double outlet right ventricle with anterior and left-sided aorta and subpulmonary ventricular septal defect

Double outlet right ventricle (DORV) is a heterogeneous group of abnormal ventriculoarterial connections where, by definition, both great arteries (pulmonary artery and aorta) arise primarily from the morphologically right ventricle. This condition affects 1-1.5% of the patients with congenital heart diseases, with a frequency of 1 in each 10,000 live births. We report the case of an 18-day-old infant with DORV and extremely rare anatomical features, such as anterior and left-sided aorta and subpulmonary ventricular septal defect (VSD). In addition to the anatomic features, the role of the echocardiogram for guiding the diagnosis and the surgical therapy of this congenital heart disease are discussed.

Conservative surgical treatment of anterior mitral valve aneurysm secondary to aortic valve endocarditis.

Marcelo L.C. Vieira, M.D.,∗ Pablo M. Pomerantzeff, M.D.,† Limbert L.S. Pillco, M.D.,‡ Joyceli Melo da Costa, M.D.,∗ Wilson Mathias Jr., M.D.,∗ Samira B. Leal, M.D.,∗ Max Grinberg, M.D.,‡ José L. Andrade, M.D.,∗ and José A.F. Ramires, M.D.‡ ∗Division of Imaging Diagnosis, Sector of Echocardiography, †Department of Cardiovascular Surgery, and ‡Department of Cardiology, Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil

Absence of an aortic valve cusp, a cause of severe aortic regurgitation in infancy

SummaryCongenital aortic regurgitation is an extremely rare cardiac lesion. This is a case report of an infant with a severe degree of valve regurgitation due to absence of the noncoronary aortic cusp. We show the echocardiographic, angiographic, and surgical aspects of the case, emphasizing the importance of a precise anatomical diagnosis and the problems of early valve replacement.

Origem anômala da artéria pulmonar direita em aorta ascendente (hemitruncus)

The origin of the right pulmonary artery from the ascending aorta is a rare congenital anomaly, with very few reports in the literature. We describe two cases of this rare malformation, one of them, associated with interruption of the aortic arch (type B). In both cases, the diagnosis was made by two-dimensional echocardiography, with angiographic confirmation in one of them. The origin of the right pulmonary artery was close to the aortic valve, anomaly pathogenetically distinct from the type that arises close to the innominate artery.The origin of the right pulmonary artery from the ascending aorta is a rare cogenital anomaly, with very few reports in the literature. We describe two cases of this rare malformation, one of them, associated with interruption of the aortic arch (type B). In both cases, the diagnosis was made by two-dimensional echocardiography, with angiographic confirmation in one of them. The origin of the right pulmonary artery was close to the aortic valve, anomaly pathogenetically distinct from the type that arises close to the innominate artery.

Myocardial bridge in a patient with sickle cell anemia

Sickle cell anemia (SCA) is a hereditary condition that occurs almost exclusively in blacks. It is characterized hematologically by the presence of sickle erythrocytes. This sickling phenomenon results from low oxygen tensions. A number of vaso-occlusive events may occur, involving the microcirculation or even large arteries. Arterial occlusion results from the interaction of remuved abnormal erythrocytes with the vascular wall. Not rarely, cases of splenic infarct and microscopic hematuria are found . Pulmonary hypertension is frequently attributed to SCA. An association with lethal and nonlethal cardiovascular events has also been reported . In spite of the potential ischemic impairment of many tissues, the literature regarding SCA’s association with coronary disease is scarce. Our objective is to report the case of a young woman with chest pain who had an association of SCA with myocardial bridge (MB).