[Transesophageal echocardiography diagnosis of perforation of the mitral valve secondary to infective endocarditis]. / Diagnóstico por ecocardiografía transesofágica de perforación de la válvula mitral secundaria a endocarditis infecciosa.

We report on a patient with infective endocarditis and severe mitral regurgitation secondary to perforation in the base of the posterior mitral leaflet. Transthoracic echocardiography was inconclusive. Only transesophageal echocardiography could confirm the presence of vegetations, their characteristics and the existence of valvular perforation. We also review the literature on the contribution of transesophageal echocardiography to the diagnosis of infective endocarditis and its complications.

Myocardial infarction and subtotal obstruction of the anterior descending coronary artery caused by trauma in a football player.

A 26-year-old professional football player had a myocardial infarction when he was practicing his sport. He arrived at the hospital 1 hour later. Angiographic study showed critical stenosis and distal thrombosis in the anterior descending coronary artery. Intracoronary thrombolytic and vasodilator therapy followed by dilatation angioplasty resolved these coronary obstructions. We conclude that several factors contributed to the origin of myocardial infarction in this case including a complicated atheromatous plaque, formation of thrombus and coronary spasm.