ABSTRACT
BACKGROUND: Chagas' disease is an important cause of heart failure, and early identification of cardiac involvement may help to identify patients at risk for disease progression. Two-dimensional (2D) speckle tracking (ST) strain seems to be a useful tool to detect incipient ventricular dysfunction. This study aims to analyze if 2D strain can detect contractility abnormalities in asymptomatic patients with Chagas' disease. METHODS: Seventy-eight asymptomatic Chagas' disease patients (46% male; age 44.7 ± 8.6 years) with normal cardiovascular exams and a control group of 38 healthy subjects (58% male; age 44.1 ± 9.2 years) were included in the study. Using 2D strain software, left ventricular (LV) end-systolic longitudinal, radial, and circumferential strain were measured. Global right ventricular (RV) longitudinal strain was also assessed. RESULTS: Echocardiographic parameters of LV systolic and diastolic function were similar between patients and controls. 2D longitudinal strain in the basal inferior, and inferoseptal walls, as well as apical segment of the inferolateral wall were lower in patients compared with controls. 2D radial strain was reduced in several segments of the LV walls as well as the global radial strain. 2D circumferential strain at the basal segment of the anterior wall showed a lower value in patients compared with controls, whereas global circumferential strain was similar between patients and controls. 2D RV strain did not differ between groups. CONCLUSION: In a subgroup of asymptomatic patients with Chagas' disease without evident cardiac involvement, 2D strain was reduced compared with healthy individuals, suggesting incipient LV dysfunction in these patients. 2D ST strain has the potential for detecting early myocardial impairment in the setting of Chagas' disease.
Subject(s)
Chagas Cardiomyopathy/diagnostic imaging , Early Diagnosis , Echocardiography/methods , Heart Ventricles/diagnostic imaging , Ventricular Dysfunction, Left/diagnostic imaging , Ventricular Function, Left/physiology , Adult , Chagas Cardiomyopathy/complications , Chagas Cardiomyopathy/physiopathology , Echocardiography, Doppler/methods , Female , Follow-Up Studies , Heart Ventricles/physiopathology , Humans , Male , Prospective Studies , Stroke Volume , Ventricular Dysfunction, Left/etiology , Ventricular Dysfunction, Left/physiopathologyABSTRACT
Noncompaction of ventricular myocardium (NVM) is a rare cardiomyopathy, most probably caused by disturbances in embryonic morphogenesis of the myocytes, resulting in prominent trabeculations in the ventricular myocardium. Several diagnostic criteria have been proposed by echocardiography, and its association with other heart diseases is common. Its mortality is closely related to ventricular dysfunction, cardiac arrhythmias, and cardioembolic events. We report here a case of occurrence of atrioventricular block with syncope as the clinical manifestation of NVM. A brief review of the literature on morphological features, diagnosis, prognosis, and treatment will also be discussed.
Subject(s)
Atrioventricular Block/diagnosis , Atrioventricular Block/physiopathology , Isolated Noncompaction of the Ventricular Myocardium/diagnosis , Isolated Noncompaction of the Ventricular Myocardium/physiopathology , Adult , Atrioventricular Block/surgery , Diagnosis, Differential , Echocardiography , Electrocardiography, Ambulatory , Female , Humans , Isolated Noncompaction of the Ventricular Myocardium/surgery , Pacemaker, ArtificialABSTRACT
Tricuspid valve lesions caused by penetrating chest trauma are rare and often underdiagnosed. The objective of this report is to describe a case of severe tricuspid insufficiency secondary to a knifing incident with an insidious evolution, diagnosed 19 years after the incident. The case emphasizes the importance of adequate follow-up of patients that are victims of penetrating chest trauma for a long period after the injury, to detect possible late complications of the trauma.
Subject(s)
Heart Injuries/complications , Tricuspid Valve Insufficiency/etiology , Tricuspid Valve/injuries , Wounds, Stab/complications , Humans , Male , Middle AgedABSTRACT
As lesões da valva tricúspide decorrentes de trauma torácico penetrante são raras e frequentemente subdiagnosticadas. O objetivo deste relato é descrever um caso de insuficiência tricúspide grave secundária a acidente por arma branca com evolução insidiosa, diagnosticada 19 anos após o ocorrido. O caso enfatiza a importância do acompanhamento adequado dos pacientes vítimas de trauma torácico penetrante por longo período após a injúria, para detecção de possíveis complicações tardias do trauma.
Tricuspid valve lesions caused by penetrating chest trauma are rare and often underdiagnosed. The objective of this report is to describe a case of severe tricuspid insufficiency secondary to a knifing incident with an insidious evolution, diagnosed 19 years after the incident. The case emphasizes the importance of adequate follow-up of patients that are victims of penetrating chest trauma for a long period after the injury, to detect possible late complications of the trauma.
Las lesiones de la válvula tricúspide resultantes de trauma torácico penetrante son raras y frecuentemente subdiagnosticadas. El objetivo de este relato es describir un caso de insuficiencia tricúspide severa secundaria a accidente por arma blanca con evolución insidiosa, diagnosticada 19 años tras lo sucedido. El caso enfatiza la importancia del seguimiento adecuado de los pacientes víctimas de trauma torácico penetrante por largo período tras la injuria, para detección de posibles complicaciones tardías del trauma.