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The article discusses mitral regurgitation (MI), a heart condition characterized by incomplete closure of the mitral valve, which causes regurgitation of blood into the left atrium. This problem can be due to various etiologies, such as degenerative or ischemic diseases, and is mainly evaluated with Doppler echocardiography, which makes it possible to measure the severity of regurgitation and study functional parameters of the heart. We present a clinical case of a 69-year-old man who was evaluated for chronic dyspnea. Initial echocardiographic studies suggested possible severe aortic stenosis, but detailed analysis revealed that the observed discharge was caused by a regurgitating stream of severe mitral regurgitation secondary to mitral vela prolapse. This simulated an elevated gradient in the aortic valve. The correct diagnosis allowed a mitral valve replacement with a favorable evolution. The coexistence of mitral regurgitation and other valvular diseases may complicate the diagnosis due to hemodynamic interactions. The use of advanced imaging techniques, such as transesophageal echocardiography, is critical to differentiate between conditions, ensure an accurate diagnosis, and guide appropriate treatment.

El artículo trata sobre la insuficiencia mitral (IM), un trastorno cardíaco caracterizado por el cierre incompleto de la válvula mitral, que causa regurgitación de sangre hacia la aurícula izquierda. Este problema puede deberse a varias etiologías, como enfermedades degenerativas o isquémicas, y se evalúa principalmente con ecocardiografía Doppler, que permite medir la severidad de la regurgitación y estudiar parámetros funcionales del corazón. Se presenta un caso clínico de un hombre de 69 años que fue evaluado por disnea crónica. Los estudios ecocardiográficos iniciales sugirieron una posible estenosis aórtica severa, pero el análisis detallado reveló que el flujo observado era causado por un chorro regurgitante de una insuficiencia mitral severa secundaria a prolapso de un velo mitral. Esto simulaba un gradiente elevado en la válvula aórtica. El diagnóstico correcto permitió realizar un reemplazo de la válvula mitral con evolución favorable. La coexistencia de insuficiencia mitral y otras valvulopatías puede complicar el diagnóstico debido a interacciones hemodinámicas. El uso de técnicas avanzadas de imagen, como la ecocardiografía transesofágica, es fundamental para diferenciar entre condiciones, garantizar un diagnóstico preciso y guiar el tratamiento adecuado.

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Abstract During the preanesthetic assessment of the obstetric patient, it is critical to assess the patient's cardiovascular baseline condition, identify any potential risks, and facilitate behavioral modification to develop an individualized management strategy aimed at minimizing complications. Cardiac point-of-care ultrasound (POCUS) is a valuable instrument for assessing the morphology and function of the heart prior to surgery. Cardiac POCUS is not designed to replace comprehensive transthoracic echocardiography, which is the realm of cardiovascular anesthesiology and cardiology. However, when used in conjunction with anamnesis, physical examination, electrocardiogram, and previous laboratory results, cardiac POCUS is a valuable adjunct in the diagnostic toolbox of anesthesiologists. It allows for direct visualization of the heart and great vessels, with added benefits of speed, availability, and low risk for the patient. The purpose of this manuscript is to explore and describe the advantages of cardiac POCUS in the preanesthetic period of obstetric patients and its potential value for anesthesiologists through the identification of potentially hazardous conditions that may require individualized preoperative management.

Resumen Durante la valoración preanestésica de la paciente obstétrica, es fundamental evaluar la condición cardiovascular basal de la paciente, identificar riesgos potenciales y facilitar modificaciones conductuales para desarrollar una estrategia de manejo individualizada, dirigida a minimizar las complicaciones. La ecografía cardíaca a la cabecera del paciente (POCUS) es un instrumento valioso para evaluar la morfología y la función del corazón antes de un procedimiento quirúrgico. El POCUS cardiaco no está diseñado para sustituir a la ecocardiografía transtorácica formal, que corresponde al área de anestesiología cardiovascular y a la cardiología. Sin embargo, cuando se usa en conjunto con la anamnesis, el examen físico, el electrocardiograma y los resultados de exámenes de laboratorio previos, el POCUS cardiaco es un complemento valioso dentro del arsenal diagnóstico de los anestesiólogos. Permite la visualización directa del corazón y de los grandes vasos, con beneficios adicionales de velocidad, disponibilidad y bajo riesgo para la paciente. El objetivo del presente manuscrito es explorar y describir las ventajas del POCUS cardiaco durante el periodo preanestésico en pacientes obstétricas y su valor potencial para los anestesiólogos, a través de la identificación de condiciones eventualmente peligrosas que pudieran requerir un manejo preoperatorio individualizado.

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Background: Despite well-established therapeutic techniques, such as direct revascularization through percutaneous coronary intervention (PCI), acute myocardial infarction (AMI) remains a leading cause of mortality and morbidity. Objectives: To determine if two-dimensional speckle tracking echocardiography (STE) deformation parameters and the early recovery of left ventricular (LV) functions are affected by the timing of PCI in AMI. Methods: A total of 200 cases with newly-onset acute myocardial infarction (AMI) who had a baseline left ventricular ejection fraction (LVEF) higher than 35% and received effective therapy with percutaneous coronary intervention (PCI) were included in this investigation. Cases were categorized as either ST-elevation myocardial infarction (STEMI) or non-ST-elevation myocardial infarction (NSTEMI). Cases were grouped into four groups according to the time between presentation and PCI. Using standard echocardiography and two-dimensional (2D) STE, individuals were re-evaluated initially and three months later to find out if remodeling had taken place or if the LV function had returned. Results: Of the 200 AMI patients, including 140 males (70%), improvement in global longitudinal strain (GLS) and harmed longitudinal strain (HLS) were better in STEMI and NSTEMI patients received urgent revascularization with PCI (groups I and III) versus patients with pharmacoinvasive strategy or routine invasive strategy (Groups II and IV) (P < 0.05) while there was an insignificant difference between group I and III (P = 0.79). Of the 200 patients, 47 patients (23.5%) presented signs of LV remodeling at 3 months follow up. Age, smoking history, hypertension, dyslipidemia, Killip class, peak creatine phosphokinase - MB level, baseline left ventricular end diastolic volume (LVEDV), HLS, and harmed longitudinal strain rate (HLSR) were all factors that were found to be significantly associated with left ventricular remodeling (P<0.05) in the univariate logistic regression analysis. The following factors were identified as independent predictors of left ventricular remodeling in multivariate logistic regression analysis: damaged left ventricular ejection fraction (EF) and end-systolic volume, peak troponin I, Killip class, culprit left anterior descending (LAD), 2 and 3-vessel coronary artery disease (CAD), and wall motion score index (WMSI). Conclusion: Earlier PCI in AMI helps earlier improvement in myocardial strain parameters. HLS and HLSR are excellent predictors for LV remodeling and may do better than global parameters.

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Background: The Quadricuspid aortic valve (QAV) is a rare; often isolated, sometimes associated with other heart diseases. We report a case of quadricuspid aortic valve. 46 yr old Female whoCase Report: came to our OPD with complaints of breathlessness, palpitations past 2 months. On further evaluation echo showed quadricuspid aortic valve , severe Aortic regurgitation. Patient was referred for surgery. The quadricuspid aorticConclusion: valve is one cause of signicant aortic regurgitation that is the predominant clinical nding. It's early recognition is particularly important for surgical management.

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A Insuficiência Cardíaca com Fração de Ejeção Preservada (ICFEp) é um desafio crescente na cardiologia, marcada por anormalidades na função sistólica e/ou diastólica. Pacientes com ICFEp frequentemente apresentam intolerância ao exercício, mas o diagnóstico é muitas vezes dificultado devido sobreposição de comorbidades, como obesidade e hipertensão. A Deformação Longitudinal Global (GLS) do ventrículo esquerdo (VE) permite a detecção de disfunções sistólicas sutis, em que estudos apontam uma correlação mais forte entre o GLS e a capacidade de realização do exercício do que a fração de ejeção (FE). Na ecocardiografia de exercício, o GLS exibe um padrão bimodal característico devido a adaptações hemodinâmicas, com desvios sugerindo ICFEp. Em caso de inviabilidade do teste de exercício ou quando a avaliação específica do acoplamento ventriculararterial é desejada, um desafio de pós-carga oferece uma alternativa controlada ao aumentar a resistência sistêmica. Além do GLS, a dispersão mecânica (MD) mede a heterogeneidade contrátil, enquanto a deformação atrial esquerda (StrainAE) se mostrou promissora na identificação de disfunção atrial ligada à ICFEp. Esses parâmetros, avaliados juntamente com as razões E/e' e a pressão sistólica pulmonar durante o exercício, melhoram o diagnóstico de ICFEp, oferecem uma visão mais abrangente da fisiopatologia da síndrome e garantem informações valiosas para fundamentar a decisão de tratamento. (AU)

Heart Failure with Preserved Ejection Fraction (HFpEF) is an increasing challenge in cardiology, marked by impairments in systolic and/or diastolic function. HFpEF patients often present with exercise intolerance, yet diagnosis is complicated by overlapping comorbidities, such as obesity and hypertension. Left ventricular Global Longitudinal Strain (GLS) enables the detection of subtle systolic dysfunction, with studies indicating a stronger correlation between GLS and exercise capacity than ejection fraction (EF). In exercise echocardiography, GLS displays a characteristic bimodal pattern due to hemodynamic adaptations, with deviations suggesting HFpEF. When exercise testing is unfeasible or when a specific evaluation of ventricular-arterial coupling is desired, an afterload challenge offers a controlled alternative by increasing systemic resistance. Beyond GLS, mechanical dispersion (MD) measures contractile heterogeneity, while left atrial strain (LAS) has shown promise in identifying atrial dysfunction linked to HFpEF. These parameters, evaluated alongside E/e' ratios and pulmonary systolic pressure during exercise, enhance HFpEF diagnosis, provide a more comprehensive view of the syndrome's pathophysiology, and offer insights to support treatment. (AU)

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Fundamento: O envolvimento cardiovascular na COVID-19 foi extensivamente estudado. A ecocardiografia é uma técnica importante na identificação do acometimento cardíaco, servindo como excelente ferramenta para variáveis prognósticas. Objetivo: Analisar o impacto prognóstico do speckle tracking na análise do ventrículo esquerdo (VE) em pacientes com COVID-19 internados em unidades de terapia intensiva (UTI). Métodos: Pacientes com diagnóstico de COVID-19 admitidos na unidade de terapia intensiva foram submetidos a exame ecocardiográfico nas primeiras 48 horas de internação e divididos em dois grupos de acordo com o desfecho hospitalar (alta ou óbito). Os dados ecocardiográficos convencionais, e de strain longitudinal global do ventrículo esquerdo (SLGVE) e ventrículo direito (SLGVD) de ambos os grupos foram comparados pelo teste t de Student (variáveis contínuas) ou pelo teste do qui-quadrado (variáveis categóricas), considerando-se como estatisticamente significativo p < 0,05. Resultados: A média de idade foi de 56 ± 14 anos, e a proporção de homens e mulheres foi semelhante. A taxa de mortalidade foi de 64%, mais frequente em pacientes idosos e em pacientes com maior número de comorbidades. O SLGVE revelou valores menores nos pacientes que evoluíram para óbito, com ponto de corte abaixo de −18,1% (sensibilidade = 90,4%, especificidade = 96,6%) para esse desfecho e, após análise estatística multivariada, foi a única variável ecocardiográfica estatisticamente significativa. I O O Conclusão: O SLGVE é uma ferramenta importante na análise prognóstica desses pacientes, oferecendo uma nova janela de possibilidades para avaliar pacientes críticos com COVID-19. (AU)

Background: Cardiovascular involvement in COVID-19 has been extensively studied. Echocardiography is an important technique in identifying cardiac involvement, serving as an excellent tool for prognostic variables. Objectives: Analyze the prognostic impact of speckle tracking in analyzing the left ventricle in patients with COVID-19 admitted to intensive care units (ICUs). Methods: Patients diagnosed with COVID-19 admitted to the ICU underwent an echocardiographic examination within the first 48 hours of hospitalization and were divided into two groups according to hospital outcome (discharge or death). Conventional echocardiographic data, as well as global longitudinal strain of the left ventricle (LVGLS) and right ventricle (RVGLS) of both groups, were compared using Student's t test (for continuous variables) or the chi-square test (for categorical variables), considering p < 0.05 as statistically significant. Results: The average age was 56 ± 14 years, and the proportion of men and women was similar. The mortality rate was 64%, more frequent in elderly patients and in patients with a higher number of comorbidities. LVGLS revealed lower values in patients who progressed to death, with a cutoff point below −18.1% (sensitivity = 90.4%, specificity = 96.6%) for this outcome, and, after multivariate statistical analysis, it was found to be the only statistically significant echocardiographic variable. Conclusion: LVGLS is an important tool in the prognostic analysis of critically patients with COVID-19, offering a new window of possibilities for evaluating these patients. (AU)

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Peripartum cardiomyopathy (PPCM) is an idiopathic, non-ischemic systolic type of heart failure which can present anytime from the last month of pregnancy till the end of 5th month post-partum. The incidence of PPCM in the Indian population is 1:1340 with 60% of the cases occurring post-partum. PPCM has a mortality rate of 11.7% with unpredictable sequelae ranging from worsening heart failure, cardiogenic shock, development of arrythmias to complete recovery and recurrence in subsequent pregnancies. With an idiopathic aetiology with multiple theories, PPCM remains a diagnosis of exclusion, demanding a high index of suspicion and surveillance in pregnant women. The management involves a multidisciplinary approach involving the obstetrician, cardiologist and at times the anaesthesiologist and includes various drugs like beta- blockers, diuretics, digoxin, bromocriptine. In severe cases, maternal circulatory support may also be needed. We present three cases of PPCM diagnosed in the antepartum, intrapartum and immediate post-partum periods respectively. Out of 3 patients, one delivered vaginally and two underwent emergency caesarean sections. All of patients went home post-delivery with good outcomes and were doing well after 4 weeks of delivery.

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Resumo Fundamento: A síndrome do PRKAG2 tipicamente se manifesta na adolescência e início da idade adulta, cursando com hipertrofia ventricular esquerda, arritmias e risco de morte súbita. O achado de marcadores ecocardiográficos antes da manifestação clínica nos filhos de pais acometidos pela doença pode facilitar a estratégia de prevenção e planejamento terapêutico para esse grupo de pacientes. Objetivo: Identificar a existência de achados ecocardiográficos que se manifestem precocemente nos filhos de pais acometidos por síndrome do PRKAG2, enquanto ainda assintomáticos. Métodos: Estudo observacional transversal em que sete participantes, filhos de pais com diagnóstico estabelecido de síndrome do PRKAG2, com idades entre 9 meses e 12 anos e diagnóstico genético comprovado, foram submetidos à ecocardiografia convencional e por técnicas avançadas, tendo seus achados comparados aos de grupo controle composto por sete voluntários pareados por sexo e idade, hígidos do ponto de vista cardiovascular. Um valor de p < 0,05 foi considerado significante. Resultados: A ecocardiografia convencional mostrou valores aumentados com significância estatística no grupo caso para átrio esquerdo, septo interventricular, parede posterior do ventrículo esquerdo, massa ventricular indexada e espessura relativa da parede (p < 0,05). O strain sistólico longitudinal global obtido pelo ecocardiograma bidimensional não mostrou diferença estatisticamente significativa entre os grupos caso e controle. Nenhum dos parâmetros ao ecocardiograma tridimensional apresentou significância estatística entre os grupos. Conclusão: Crianças diagnosticadas com PRKAG2 demonstraram achados ecocardiográficos indicativos de tendência à hipertrofia cardíaca. A ecocardiografia pode ser uma ferramenta útil na avaliação e seguimento desse grupo de pacientes, antes do início de manifestações clínicas.

Abstract Background: PRKAG2 syndrome typically manifests in adolescence and early adulthood, progressing with left ventricular hypertrophy, arrhythmias, and risk of sudden death. Findings of echocardiographic markers before clinical manifestation in children of patients affected by the disease can facilitate prevention strategies and therapeutic planning for this patient group. Objective: To identify the existence of echocardiographic findings that manifest early in children of parents affected by PRKAG2 syndrome, while they are still asymptomatic. Methods: In this cross-sectional observational study, 7 participants who were children of parents with established diagnosis of PRKAG2 syndrome, between the ages of 9 months and 12 years, with proven genetic diagnosis, underwent conventional and advanced echocardiography. Their findings were compared to those of a control group composed of 7 age- and sex-matched volunteers who were healthy from a cardiovascular point of view. P values < 0.05 were considered significant. Results: Conventional echocardiography showed statistically significantly higher values in the case group for left atrium, interventricular septum, left ventricular posterior wall, indexed ventricular mass, and relative wall thickness (p < 0.05). Global longitudinal systolic strain on 2-dimensional echocardiography did not show statistical significance between the case and control groups. None of the parameters on 3-dimensional echocardiography showed statistical significance between groups. Conclusion: Children diagnosed with PRKAG2 showed echocardiographic findings indicative of a tendency toward cardiac hypertrophy. Echocardiography can be a useful tool in the evaluation and follow-up of this patient group before the onset of clinical manifestations.

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Resumo Fundamento A ecocardiografia é essencial para avaliação do coração transplantado. No entanto, os valores de normalidade no transplante cardíaco (TC) não estão claramente definidos. Objetivos: Comparar parâmetros ecocardiográficos convencionais e pela técnica de Speckle Tracking entre pacientes transplantados cardíacos sem rejeição e uma população de indivíduos saudáveis. Métodos Foram estudados prospectivamente pacientes adultos, com menos de 1 ano de TC, que realizaram biópsia endomiocárdica de vigilância seguido de ecocardiograma transtorácico (ETT). Medidas convencionais de ETT acrescidas da avaliação de mecânica cardíaca por meio do Strain pelo Speckle Tracking foram realizadas e comparadas com um grupo de voluntários saudáveis. A significância estatística adotada para o estudo foi de 5%. Resultados Avaliou-se 36 pacientes transplantados sem rejeição, os quais foram comparados com 30 indivíduos saudáveis. Observou-se redução nos valores de Strain Global Longitudinal de Ventrículo Esquerdo em valor absoluto (11,99% transplantados, 20,60% controle, p<0,0001), Strain de parede livre de Ventrículo Direito (transplantados 16,67%, controle 25,50%, p<0,0001) e dos índices de trabalho miocárdico (p<0,0001), maior tamanho do átrio esquerdo (38,17 ml/m2 transplantados, controle 18,98 ml/m2, p<0,0001), maior índice de massa e espessura relativa das paredes (p<0,0001) e a presença da Doença de Chagas como principal etiologia para o transplante. Conclusão Os transplantados cardíacos estáveis e sem rejeição apresentaram diferenças com relação aos parâmetros ecocardiográficos comparados com indivíduos saudáveis. Estes achados indicam que medidas ecocardiográficas convencionais e de mecânica cardíaca são alteradas em transplantados mesmo na ausência de rejeição e podem ser relevantes para o contexto clínico e acompanhamento dos pacientes.

Abstract Background Echocardiography is essential for the assessment of patients with heart transplants. However, normal values in such individuals are not clearly defined. Objectives To compare conventional echocardiographic and speckle tracking variables between patients with unrejected heart transplants and healthy individuals. Methods : A prospective study was conducted with adult patients having undergone heart transplantation at least one year earlier and submitted to endomyocardial biopsy followed by transthoracic echocardiogram (TTE). Conventional TTE measures and mechanical heart strain assessments using speckle tracking were performed and the results were compared to those of a group of healthy volunteers. Statistical significance was set at 5% (p < 0.05). Results Thirty-six transplant patients without rejection were analyzed and compared to 30 healthy individuals. Chagas disease was the main reason for transplantation. Lower left ventricular global longitudinal strain expressed in absolute values was found (11.99% in transplant patients vs. 20.60% in controls; p <0.0001), right ventricular free wall longitudinal strain (16.67% in transplant patients vs. 25.50% in controls; p <0.0001) and myocardial work indices (p < 0.0001) as well as a larger size of the left atrium (38.17 ml/m2 in transplant patients vs. 18.98 ml/m2 in controls; p <0.0001) and greater mass and relative wall thickness (p <0.0001). Conclusion Stable patients having undergone heart transplants without rejection have differences concerning echocardiographic variables compared to healthy individuals. These findings indicate that conventional echocardiographic measures and heart mechanics are altered in transplant patients even in the absence of rejection. Such findings are relevant to the clinical context and follow-up of the patient.

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Background: Detecting congenital heart disease (CHD) early is crucial for better outcomes, but most newborns show no symptoms. Newborn screening for CHD can identify such cases preventing serious consequences. This study aims to determine CHD prevalence and evaluate the effectiveness of pulse oximeter screening and clinical examination, correlating them with echocardiography findings.Methods: A cross-sectional study was conducted to screen for CHD in all newborns born in our institution over a period of 3 months. A sample of 660 newborns were screened by pulse oximeter screening and clinical examination after random sampling.Results: Comparison of baseline data like age distribution in mothers, gender and gestational age were comparable between newborns with CHD and those without CHD. A total of 8 CHDs were picked up after screening 660 newborns screened during a period of 3 months. CHDs that were picked up included hypoplastic left heart syndrome, pulmonary atresia, bicuspid aortic valve, transposition of great arteries, coarctation of the aorta, and other complex CHDs. It was found that either clinical examination or pulse oximeter screening has higher sensitivity than pulse oximetry screening or clinical examination alone.Conclusions: For identification of a CHD in newborns after 24 hours of birth the order of preference for screening based on sensitivity is as follows-either pulse oximeter screening or clinical examination >clinical examination >pulse oximeter screening >pulse oximeter screening and clinical examination.

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Isolated persistent left superior vena cava (PLSVC) is a very rare congenital thoracic venous system anomaly and is commonly an incidental finding, usually detected during central venous access, cardiac catheterization, or cardiothoracic surgeries. This is a rare case report wherein the patient is a known case of ischemic heart disease with s/p percutaneous transluminal coronary angioplasty (PTCA) with a stent to left anterior descending (LAD) artery with in?stent re?stenosis presented with complete heart block and had an unanticipated discovery of isolated PLSVC on facing difficulty during the transvenous approach of permanent pacemaker implantation (PPI). In this case report, we inspect the challenges associated with and various clinical implications of isolated PLSVC.

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Intraoperative aortic dissection is a life?threatening emergency. The prognosis of patients with aortic dissection has markedly improved in recent years due to prompt diagnosis and the institution of effective medical and surgical therapy. Transesophageal echocardiography (TEE) is helpful in the evaluation of this life?threatening disorder.

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Transesophageal echocardiography (TEE) has become an essential monitor for the management of most patients undergoing cardiothoracic surgery. TEE and central venous catheter placement are often used during cardiac surgeries. Here we conducted a study comparing TEE 3D probe as a surface probe with the ultrasound?guided (USG) vascular probe for guiding right internal jugular vein (IJV) catheterization. Context: USG vascular probe and TEE probe can help during central venous catheterization (CVC) and can confirm the location of guide wire in the neck vessels. We proposed this study, as there are only few studies comparing between TEE probe as surface probe and USG vascular probe for right IJV cannulation. Aims: To compare the TEE probe as a surface probe and USG vascular probe during right IJV catheterization in cardiac surgeries. Settings and Design: Prospective, comparative study. Methods and Material: One twenty?four patients of either sex posted for major elective cardiac surgery were included in this study. Patients were divided into two groups (TEE group and USG group) of 62 by assigning the study participants alternatively to each group. The goal of this study was to compare the puncture time, visualization of IJV to first successful puncture, quality of the imaging with needle tip positioning, and catheter positioning using both TEE probe and vascular probe. The primary outcome was comparison of time from visualization of the IJV to successful puncture using both TEE probe as a surface probe and vascular probe. Secondary outcome was to compare the quality of image with respect to needle tip positioning and compare quality of image with respect to catheter position using both probes. Statistical Analysis Used: Statistical analyses were performed by using a statistical software package SPSS, version 20.0. Results: The observation and results of our study clearly show the feasibility of TEE as surface probe for guiding central venous catheter in right IJV just like the vascular linear probe. There was no significant difference between the two groups ( P > 0.05). No statistical differences were found in the puncture time, image quality, needle tip positioning, wire positioning, and catheter positioning between the two groups. All the P values were greater than 0.05. Conclusions: The TEE probe can be used as an alternative method to guide IJV puncturing and catheterization when the vascular probe is not available. It is feasible especially in cardiac surgeries where the TEE monitoring machine is a must in modern anesthesia and readily available than an ultrasound machine.

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Background: The utilization of two-dimensional speckle-tracking echocardiography (2-D STE) serves as a precise measurable technique for conducting an assessment of both global and localized cardiac performance, exhibiting remarkable sensitivity. Its utility is particularly noteworthy in the early identification of cardiac impairments that are not clinically evident. This study’s objective was to investigate the effectiveness of STE in identifying latent left ventricular dysfunction among individuals who have recuperated from COVID-19. Methods: This study was conducted at a single center; this analytical cross-sectional analysis involved 100 individuals over the age of 18. The study comprised two cohorts: one with 50 post COVID-19 patients, confirmed through a positive PCR test within a month of diagnosis, and a control group of 50 healthy subjects be compatible for age, sex, and risk factors. Subsequently, the post COVID-19 patients were stratified based on high-sensitivity troponin levels into two subgroups: Group I included those exhibiting signs of myocardial damage, while Group II consisted of patients showing no evidence of myocardial injury. Results: Elderly individuals, a greater prevalence of hypertension (HTN), raised levels of D-dimer and, serum C-reactive protein (CRP) along with increased Left ventricular end-diastolic volume (LVEDV) and diminished Left ventricular global longitudinal strain (LVGLS) over a one-month observation period, were all significantly linked to myocardial injury, as indicated by a p-value < 0.05. The LVGLS was a reliable indicator of cardiac injuries in COVID-19 survivors, with an AUC of 0.947 and a CI ranging from 0.886 to 1.00 (P < 0.001), particularly at a threshold of ? -20%, where it achieved 87.2% sensitivity and 100% specificity. Approximately 35 patients exhibited an LVGLS below this threshold. Furthermore, D-dimer and CRP levels post COVID-19 were notably elevated in those with cardiac injuries in comparison with those not, a difference that was statistically significant (P < 0.05). Furthermore, during the follow-up after one month period, post COVID-19 CRP levels, LVEDV, and LVGLS remained significantly higher in patients with myocardial injury in comparison with those didn’t have myocardial injury (p < 0.05). Conclusions: LV GLS is acknowledged as a noteworthy, autonomous predictor of outcome for myocardial injury in individuals diagnosed with COVID-19. This metric offers preliminary insights into the infection’s severity, potentially aiding in the early intervention and management strategies for affected patients.

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Background: Right ventricular (RV) dysfunction is prevalent in children with congenital heart disease (CHD), particularly in association with pulmonary hypertension (PH). Transthoracic echocardiography (TTE) is crucial for detecting, assessing severity, and monitoring CHD patients with PH. The current study aimed to compare RV function assessed by TTE between CHD patients with PH and healthy children.Methods: The case group comprised CHD patients diagnosed with PH via TTE and confirmed by cardiac catheterization. The control group included children with normal echocardiograms. A total of 40 patients were enrolled based on predefined criteria.Results: The study included 20 cases and 20 controls. Echocardiographic parameters revealed significant differences between the case and control groups, with increased RV dimensions in the case group, except for RV subcostal wall thickness. RV systolic function parameters, including tricuspid annular plane systolic excursion (TAPSE) and tricuspid annular systolic velocity (S'), were significantly lower in the case group. RV diastolic function parameters, including E/A ratio, E/e', and deceleration time (DT), were also significantly different between the groups. The RV global function parameter, tissue Doppler imaging-derived myocardial performance index (TD MPI), was significantly higher in the case group.Conclusions: Echocardiographic evaluation of RV function, including TAPSE, S', TD MPI, E/A ratio, E/e', and DT, in CHD children with PH correlates with PH severity. This assessment can aid in early detection of PH severity before irreversible changes occur and serve as an alternative to right heart catheterization.

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Dilated Cardiomyopathy (DCM) is defined by a left ventricle (LV) with reduced systolic function (<45%) and dilation (LV volume > 90 ml/m²), excluding coronary artery disease or sufficient load conditions to explain it. The etiologies are multiple and increasingly well-known. We conducted a single-centre, retrospective observational study within the cardiology department of the CHU IBN ROCHD in Casablanca, Morocco, over one year. The main objective was to describe the characteristics and particularities of patients followed for DCM. The diagnosis is based only on echocardiography, after exclusion of an ischemic cause, severe valvular disease, and congenital heart disease. During the study, 44 patients were included, with a male predominance of 63.6% versus 36.4%. The average age was 60 ± 16.8 years. The initial presentation of cardiomyopathy showed that 73% of patients were admitted with heart failure (HF). The mean left ventricular ejection fraction (LVEF) was 30.2 ± 7.9%. Among the attributed etiologies, idiopathic DCM was the main cause reported in 59% of cases, followed by systemic lupus erythematosus (14%) and myocarditis (14%). In our sample, treatment was based on HF management, including beta-blockers, renin-angiotensin system blockers, SGLT2 inhibitors, and aldosterone antagonists. Implantation of a defibrillator for primary prevention concerned only one patient (3%) of the 33 patients for whom the theoretical indication was retained.

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Introduction: Rare cardiomyopathy left ventricle non-compaction (LVNC) or excess trabeculation is an unclassified heart disease related to the cessation of the normal process of myocardial development during the first trimester of pregnancy. Familial forms account for approximately half of the cases, and men are the most affected. The usual clinical presentation corresponds to the classic triad, which includes heart failure, arrhythmias, and thromboembolic manifestations. Case Presentation: Here, we describe the case of a 56-year-old man with no pathological history who consulted for dyspnea, and in whom transthoracic echocardiography and magnetic resonance imaging have made it possible to retain the diagnosis of an excess of trabeculations complicated by heart failure and an apical thrombus. Conclusion: LVNC is a rare cardiomyopathy that frequently affects men and is diagnosed using echocardiography and in borderline cases, supplemented by cardiac MRI.

ABSTRACT

Background: Long-term hypertension is a substantial risk factor for coronary artery disease, stroke, heart failure, peripheral vascular disease, vision loss, and chronic kidney disease. Not only is echocardiography the most adaptable imaging technique for the cardiovascular system but it is also the most comprehensive and dependable hemodynamic tool. Aim and Objective: The purpose of this study was to analyze echocardiographic results in hypertensive patients. Material and Methods: It was a cross-sectional study of hypertension patients admitted to the medicine wards of the civil hospital connected to the P.D.U. Government Medical College in Rajkot, Gujarat, India. After considering inclusion and exclusion criteria, hypertensive patients were chosen at random for enrollment in the study. A total of 50 patients with hypertension were investigated. A skilled cardiologist performed the echocardiographic examinations. To simplify the observations made in the study, patients were separated into four groups based on their wall motion score. Results: The number of patients with systolic blood pressure of 169–179 mmHg was 32% (16 patients), while the number of patients with 140 mmHg was 18% (9 patients). Systolic blood pressure of 140–159 mmHg has 28% (14 patients) and more than 180 mmHg has 22% (11 patients). The most prevalent diastolic hypertension group had 22 patients (44%), and it was also the most common group among both sexes. Males had 12 patients with 90–90 mmHg and females had 10 individuals with 90–99 mmHg. Out of 50 hypertension patients, 21 (42%) had aberrant regional wall motion, while the remaining patients had no abnormal regional wall motion. In terms of diastolic function, 42 of 50 patients (84%) had diastolic dysfunction. Conclusion: Echocardiography is a valuable tool for assessing the consequences of hypertension in patients. It is also a widely and most regularly utilized imaging modality in cardiology practice due to its non-invasiveness and ease of access.