RESUMO
OBJECTIVE: We aim to study left atrial (LA) strains in patients with hypertensive response to exercise (HRE) and determine their usefulness in predicting masked hypertension (HT). METHODS: Ninety-eight normotensive patients who had HRE were included and were divided into two groups after masked HT had been diagnosed by ambulatory blood pressure monitoring. Conventional echocardiographic parameters and two-dimensional speckle-tracking echocardiography-based LA strain parameters were compared. RESULTS: Patients with masked HT have higher left ventricle mass index (LVMI) (88.1±11.3 vs. 82.5±8.7 g/m, P<0.05), left atrium maximum volume index (LAVI) (34.5±5.1 vs. 30.2±5.6 ml/m, P<0.001), lower global longitudinal LA strain during ventricular systole (GLAs-res) (32.5±8.9 vs. 40.2±9.1%, P<0.001), and lower global longitudinal LA strain during late diastole (GLAs-pump) (15.8±4.1 vs. 18.1±5.8%, P<0.05). In univariate analysis, a good negative correlation was found between GLAs-res versus LAVI (r=-0.451, P<0.001), GLAs-res versus LVMI (r=-0.457, P<0.001) and a moderate negative correlation was present between GLAs-pump versus LAVI (r=-0.317, P<0.001) and GLAs-pump versus LVMI (r=-0.288, P<0.05). GLAs-res and LAVI were found to be independent predictors of masked HT. Receiver-operating characteristic analysis was carried out. Area under the curve to predict masked HT was 0.729 (95% confidence interval: 0.623-0.832, P<0.001). GLAs-res less than 33.1% predicted masked HT with 73% sensitivity and 61.5% specificity. CONCLUSION: LA strain parameters were impaired in patients with masked HT and can be used to predict the presence of masked HT in patients with HRE.
Assuntos
Monitorização Ambulatorial da Pressão Arterial , Pressão Sanguínea , Ecocardiografia sob Estresse , Exercício Físico , Hipertensão Mascarada , Adulto , Feminino , Átrios do Coração/diagnóstico por imagem , Átrios do Coração/fisiopatologia , Humanos , Masculino , Hipertensão Mascarada/diagnóstico por imagem , Hipertensão Mascarada/fisiopatologia , Pessoa de Meia-IdadeRESUMO
BACKGROUND: Few studies have suggested association between mitral annular calcification (MAC) and osteoporosis in women who are post-menopausal. However, the association of MAC with osteoporosis in women, in relation to bone resorption, as assessed by using the dual-energy x-ray absorptiometry method (DEXA), have not been performed. We sought to examine the association between MAC and osteoporosis. METHODS: In this prospective, observational study carried out in a tertiary referral center, 340 women (mean age +/- SD, 56 +/- 10 years; age range, 33-85 years) underwent echocardiography, with specific assessment of MAC and bone mineral density measurement (T-scores) using DEXA. RESULTS: MAC was absent in 123 patients (group I) and present in 217 patients (group II). Compared with the control group, the group with MAC had a significantly higher prevalence and severity of osteoporosis (18.2% vs 55.5%, P <.001). Severe osteoporosis was significantly more common in the severe MAC subgroup (n = 66) than in the control subjects (65.2% vs 17.1%; Pearson chi2, 70.02; df = 4; P <.001). With multivariate analysis, only T-scores and age were highly predictive of MAC, with an odds ratio of 2.66 (95 % CI, 1.85-3.83) and 1.04 (95% CI, 1.01-1.07), respectively. CONCLUSIONS: MAC is associated with osteoporosis. Bone mineral density measurement (T-scores) and age were highly predictive of MAC in women.
Assuntos
Calcinose/epidemiologia , Doenças das Valvas Cardíacas/epidemiologia , Valva Mitral/diagnóstico por imagem , Osteoporose/epidemiologia , Pós-Menopausa , Absorciometria de Fóton , Adulto , Idoso , Idoso de 80 Anos ou mais , Calcinose/diagnóstico , Estudos de Casos e Controles , Comorbidade , Diabetes Mellitus/epidemiologia , Ecocardiografia , Feminino , Doenças das Valvas Cardíacas/diagnóstico , Humanos , Hipercolesterolemia/epidemiologia , Hipertensão/epidemiologia , Pessoa de Meia-Idade , Análise Multivariada , Osteoporose/diagnóstico , Valor Preditivo dos Testes , Prevalência , Estudos Prospectivos , Fatores de Risco , Fumar/epidemiologiaRESUMO
Interrupted aortic arch (IAA) is an uncommon and usually lethal congenital malformation. The present report describes an unusual case of IAA, an aneurysmal ascending aorta and a bicuspid aorta in a 15-year-old boy. He presented with general malaise, weakness of his legs, headache and hypertension that began six months earlier. He had suffered from effort intolerance since childhood. A three-dimensional gadolinium contrast-enhanced magnetic resonance angiogram demonstrated IAA and a markedly developed collateral circulation. IAA is an uncommon disease that is rarely encountered in an adolescent patient with nonspecific symptoms or hypertension. The present case also shows the clinical value of three-dimensional gadolinium contrast-enhanced magnetic resonance angiography for noninvasive assessment of the aortic arch, and magnetic resonance angiography can replace angiography in the assessment of aortic arch anomalies and visualization of well-developed collaterals.
Assuntos
Aorta Torácica/anormalidades , Cardiopatias Congênitas/diagnóstico por imagem , Cardiopatias Congênitas/cirurgia , Angiografia por Ressonância Magnética/métodos , Adolescente , Aorta Torácica/cirurgia , Implante de Prótese Vascular/métodos , Seguimentos , Hemodinâmica , Humanos , Masculino , Radiografia , Medição de Risco , Índice de Gravidade de Doença , Resultado do TratamentoRESUMO
OBJECTIVE: It has been reported that the loss of cell membrane integrity during severe reversible ischaemia results in elevation of plasma troponin T (TnT) in unstable angina. We investigated whether TnT is released into circulation during severe ischaemia (e.g. on treadmill exercise testing) in patients with chronic coronary artery disease (CAD). METHODS AND RESULTS: The study comprised 54 patients who had angiographically documented CAD (22 of them had a prior history of myocardial infarction) and 18 normal subjects. All cases underwent exercise thallium (Tl)-201 SPECT myocardial perfusion imaging. Blood samples for TnT analysis were obtained for each patient at pre-exercise, immediately after and 12 hours after exercise. SPECT images were divided into 20 segments. Patients with redistribution defects > or = 5 were considered to have severe ischaemia. Sixteen patients had severe ischaemia on SPECT images. The mean TnT levels of the patients with severe ischaemia at pre-exercise, immediately after and 12 hours after exercise were 0.009 +/- 0.008, 0.012 +/- 0.009 and 0.010 +/- 0.010 ng/ml, respectively. In normal subjects the mean TnT levels were 0.012 +/- 0.009, 0.010 +/- 0.009, 0.010 +/- 0.010 ng/ml, respectively. There was no significant difference neither between the two groups nor within each group with respect to pre-exercise and post-exercise TnT results. All TnT levels were within normal limits (< 0.1 ng/dl). Additionally, when the patients were grouped according to other SPECT variables (patients with reversible defects vs. fixed defects; patients with increased lung uptake of Tl-201 vs. without lung uptake; patients with transient left ventricle dilatation vs. those without) and angiographic findings (patients with multivessel disease vs. normal subjects), there were no significant differences with respect to pre-exercise and post-exercise TnT results. CONCLUSION: Severe ischaemia does not result in the elevation of the plasma TnT level in patients with chronic CAD.
Assuntos
Doença das Coronárias/sangue , Teste de Esforço , Isquemia Miocárdica/sangue , Troponina T/sangue , Adulto , Idoso , Doença Crônica , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Isquemia Miocárdica/diagnóstico por imagem , Estudos Prospectivos , Radioisótopos de Tálio , Tomografia Computadorizada de Emissão de Fóton ÚnicoRESUMO
OBJECTIVE: It has been suggested that the insertion (I)/deletion (D) polymorphism of the angiotensin-converting enzyme (ACE) may be associated with atherosclerosis. The aim of the study was to examine the association between ACE gene polymorphism and coronary heart disease in Turkish type 2 diabetic patients. METHODS AND RESULTS: A total of 152 (97 female, 55 male) type 2 diabetic patients were included into the study. All patients underwent myocardial perfusion scintigraphic examination and forty-five of them with a perfusion defect underwent coronary angiography.Thirty-eight patients with a coronary stenosis of more than 50% on coronary angiography were considered as having coronary heart disease. The I/D polymorphism was determined by polymerase chain reaction. There was no statistically significant difference in genotypic and allelic frequencies of the ACE I/D polymorphism among patients with and without coronary heart disease (DD:ID:II (%), 32:58:11 and 39:44:17, respectively). CONCLUSIONS: ACE gene polymorphism is not a significant parameter to determine coronary heart disease in Turkish type 2 diabetic patients.
Assuntos
Doença das Coronárias/genética , Diabetes Mellitus Tipo 2/genética , Angiopatias Diabéticas/genética , Peptidil Dipeptidase A/genética , Polimorfismo Genético/genética , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase , TurquiaRESUMO
OBJECTIVE: This study sought to evaluate the potential prognostic usefulness of QT dispersion (QTd) in patients with unstable angina. METHODS AND RESULTS: QTd was calculated and plasma troponin T (TnT) level was measured and rest perfusion imaging with Tc-99m sestamibi was performed in 62 patients admitted with chest pain at rest. All patients had a follow-up during one month in order to assess cardiac events. Cardiac events occurred in 41 patients (no deaths, 11 myocardial infarctions (MI), 4 urgent and 26 planned revascularizations). The mean QTd in patients with cardiac events was significantly higher than in those without cardiac events (68 +/- 28 vs. 54 +/- 14 ms; p = 0.01). When patients were divided into subgroups according to the cardiac events, the mean QTd in MI and revascularization were 90 +/- 25 ms and 60 +/- 25 ms, respectively. QTd in patients with MI was higher than in patients without cardiac events (p = 0.001). There was no significant difference in QTd between the revascularization subgroup and patients without cardiac events. Nineteen patients with elevated TnT had a greater QTd compared to patients with normal TnT (74 +/- 29 vs. 56 +/- 20 ms; p = 0.008). Additionally, the mean QTd in 46 patients with perfusion defects was slightly higher than in patients without (66 +/- 27 vs. 53 +/- 17 ms; p = 0.03). There was also a moderate correlation between QTd and the number of perfusion defects (r = 0.31, p = 0.01). On the other hand, most of the patients who had a MI or urgent revascularization had a QTd greater than 75 ms. CONCLUSION: The measurement of QTd in patients with unstable angina may help to stratify patients at high risk for cardiac events, in particular MI and urgent revascularization.
Assuntos
Angina Instável/diagnóstico , Eletrocardiografia , Troponina T/sangue , Angina Instável/diagnóstico por imagem , Angina Instável/fisiopatologia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Medição de Risco , Tomografia Computadorizada de Emissão de Fóton ÚnicoRESUMO
OBJECTIVE: This study was performed to determine the effect of homocysteine-lowering therapy (HLT) on endothelium-dependent vasodilation (EDD) and exercise performance in patients with coronary artery disease. METHODS AND RESULTS: Among the patients who were on the waiting list for coronary intervention, 26 male patients (plasma homocysteine (Hcy) levels > 15 micromol/l) who had a focal stenosis of at least 70% in the left anterior descending artery were included in the study. The patients were matched to receive HLT (n = 15; 0.4 mg of folic acid, 2 mg vitamin B6 and 6 microg of vitamin B12) or placebo (n = 11) until the coronary intervention was performed (mean 3.8 +/- 0.9 weeks). Brachial artery vasomotion test and treadmill stress testing were performed at baseline and 4 weeks after HLT before the time of coronary intervention in each patient. Hcy levels were found to be decreased significantly after HLT compared to baseline (23.4 +/- 6 vs. 11.3 +/- 4 micromol/l; p < 0.001) whereas placebo had no effect. HLT but not placebo produced a marked improvement in EDD, from 3.9 +/- 1.1% to 9.4 +/- 2.3% (p < 0.0001). Endothelium-independent nitroglycerin-induced dilation was similar in the HLT and placebo groups compared with the baseline. In the exercise testing, HLT resulted in a significant improvement in exercise duration and reduction in the amount of maximal ST-segment depression, (from 6.5 +/- 2 to 6.9 +/- 2 min, p = 0.02 and from 1.2 +/- 0.7 to 0.8 +/- 0.5 mm, p = 0.01, respectively) whereas placebo did not. CONCLUSION: Lowering Hcy levels improves EDD and exercise performance while reducing the exercise-induced myocardial ischaemia in patients with coronary heart disease and hyperhomocysteinaemia.
Assuntos
Doença das Coronárias/tratamento farmacológico , Endotélio Vascular/efeitos dos fármacos , Ácido Fólico/uso terapêutico , Homocisteína/sangue , Vitamina B 12/uso terapêutico , Vitamina B 6/uso terapêutico , Idoso , Análise de Variância , Velocidade do Fluxo Sanguíneo , Artéria Braquial/diagnóstico por imagem , Angiografia Coronária , Doença das Coronárias/fisiopatologia , Método Duplo-Cego , Quimioterapia Combinada , Endotélio Vascular/fisiopatologia , Teste de Esforço , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Ultrassonografia , Vasodilatação/efeitos dos fármacosRESUMO
Pseudohypoparathyroidism (PHP) is a rare disorder characterized by varying degrees of unresponsiveness to parathyroid hormone. Patients usually present with hypocalcemia-induced seizures or tetany, whereas no case of hypocalcemia-induced cardiac arrhythmia in PHP has been described to date. In this paper, we report the case of a male adolescent with PHP type 1a who presented with hypocalcemia-induced ventricular extrasystoles (bigeminy, trigeminy) and mild corrected QT interval prolongation. The patient had brachydactyly and his second fingers and toes were longer than the others, a finding consistent with PHP. Laboratory tests detected hypomagnesemia, as well as elevated levels of creatine kinase and lactate dehydrogenase. Ventricular arrhythmia and abnormal laboratory tests improved with calcium supplementation and vitamin D treatment. The findings in this patient suggest that hypomagnesemia may make patients with PHP more susceptible to hypocalcemia and may thus prompt a state of hypocalcemia-induced arrhythmia or other cardiac complications.
Assuntos
Pseudo-Hipoparatireoidismo/complicações , Taquicardia Ventricular/diagnóstico , Adolescente , Braquidactilia/complicações , Cálcio/uso terapêutico , Humanos , Hipocalcemia/complicações , Masculino , Taquicardia Ventricular/tratamento farmacológico , Taquicardia Ventricular/etiologia , Resultado do Tratamento , Vitamina D/uso terapêutico , Vitaminas/uso terapêuticoRESUMO
The mean platelet volume (MPV) values reflect platelet size and are accepted as marker of platelet activation. We sought to test the hypothesis that platelet activation occurs independently from presence or absence of thrombus in prosthetic mitral valve. A total of 168 patients were included in the study. Study participants were divided in three groups: group 1 (n = 62) - patients with normal prosthetic mitral valve; group 2 (n = 37) - patients with prosthetic mitral valve thrombosis; and group 3 (n = 69) - healthy individuals. MPV values were significantly higher in normal and thrombotic prosthetic mitral valve patients than in healthy individuals (P = 0.008 and P = 0.01, respectively). MPV values were not different between normal prosthetic mitral valve and thrombotic prosthetic mitral valve. This is the first study indicating that increased MPV is present in normal and thrombotic prosthetic mitral valve, implying that platelet reactivity occurs in prosthetic mitral valve irrespective of development of thrombus formation.
Assuntos
Plaquetas/citologia , Próteses Valvulares Cardíacas , Valva Mitral/fisiologia , Trombose/sangue , Ecocardiografia Doppler/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valva Mitral/diagnóstico por imagem , Ativação Plaquetária , Trombose/diagnóstico por imagemRESUMO
OBJECTIVE: Mitral valve repair has become the procedure of choice for almost every type of mitral regurgitation (MR) in the current surgical era. We assessed clinical outcomes of mitral valve repair in severe MR. METHODS: In this prospective cohort study, 103 patients (61 male, 42 female, mean age 53.2±14.8 years), who were planned to undergo valve repair were included. Mitral valve pathology was regurgitant in 86% and mixed in 14% of patients. The intention to perform mitral repair was successful in 100 (97.1%) of patients. Concomitant procedures were performed in 57 (57%) patients including 31 coronary artery bypass grafting and 13 tricuspid valve repairs. After surgery, early (<30 days) and late (>30 days) complications were recorded. Postoperative echocardiography was performed in all patients at discharge and during clinical follow-up. Late survival and freedom from adverse events including thromboembolism, endocarditis, reoperation, and residual severe MR were estimated by using the Kaplan-Meier survival analysis. RESULTS: There was no early mortality. Echocardiographic assessment of patients at discharge revealed no/trivial regurgitation in 89% and mild (1+) MR in 11% of all patients. Late mortality occurred in only one patient at 14 months because of renal failure. The mean follow-up period of patients was 21.2±10.3 months. Echocardiographic examination during follow-up revealed that mitral insufficiency was none or mild in 96% of patients. Three (3%) patients had moderate (2+) MR and were treated medically. Mitral insufficiency recurrence with severe (3+) regurgitation occurred in one (1%) patient undergoing coronary artery revascularization and concomitant left ventricular aneurysmectomy. Re-operation was needed in only one (1%) case because of infective endocarditis that was treated with mechanical valve replacement. Kaplan-Meier estimates were 99±2.7% for late survival and 98±2.2%, 99±2.7%, 99±2.7% and 99±0.9% for freedom from thromboembolism, endocarditis, reoperation, and residual severe MR, respectively. CONCLUSION: This study showed that mitral valve repair provides excellent surgical outcomes. Repair procedures are safe, and highly effective, but operations require a considerable surgical experience.
Assuntos
Implante de Prótese de Valva Cardíaca , Insuficiência da Valva Mitral/cirurgia , Valva Mitral , Adolescente , Adulto , Idoso , Criança , Estudos de Coortes , Ponte de Artéria Coronária , Ecocardiografia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Insuficiência da Valva Mitral/diagnóstico por imagem , Insuficiência da Valva Mitral/mortalidade , Insuficiência da Valva Mitral/fisiopatologia , Complicações Pós-Operatórias , Estudos Prospectivos , Índice de Gravidade de Doença , Análise de Sobrevida , Resultado do Tratamento , Turquia/epidemiologia , Adulto JovemAssuntos
Dissecção Aórtica/etiologia , Aneurisma Coronário/etiologia , Pulmão Hipertransparente/complicações , Adulto , Dissecção Aórtica/diagnóstico por imagem , Aneurisma Coronário/diagnóstico por imagem , Angiografia Coronária , Humanos , Pulmão Hipertransparente/diagnóstico por imagem , Masculino , Radiografia Torácica , Tomografia Computadorizada por Raios XAssuntos
Aneurisma/diagnóstico , Artéria Pulmonar/patologia , Embolia Pulmonar/etiologia , Aneurisma/complicações , Pressão Sanguínea , Diagnóstico Diferencial , Erros de Diagnóstico , Dispneia/diagnóstico , Dispneia/etiologia , Feminino , Humanos , Pneumopatias Obstrutivas/diagnóstico , Pessoa de Meia-Idade , Embolia Pulmonar/diagnósticoAssuntos
Antibióticos Antineoplásicos/efeitos adversos , Doxorrubicina/efeitos adversos , Cardiopatias/induzido quimicamente , Antibióticos Antineoplásicos/farmacologia , Diagnóstico Diferencial , Doxorrubicina/farmacologia , Cardiopatias/etnologia , Cardiopatias/prevenção & controle , Humanos , Medição de Risco , Fatores de RiscoRESUMO
An 18-year old woman presented with progressive dyspnea and cough. Physical examination revealed decreased breath sounds at the left hemithorax and distant heart sounds with no murmurs or rub. Electrocardiogram revealed low voltage. Chest X-ray showed unilateral left-sided pleural effusion with no cardiomegaly. Transthoracic echocardiogram showed thickened pericardium localized throughout the left ventricle impairing the diastolic filling. Doppler waveforms were suggestive of localized constrictive pericarditis. A computerized tomographic scan of the chest confirmed the presence of unilateral pleural effusion with thickened pericardium surrounding the left ventricle. The patient's symptoms and signs were related to localized constrictive pericarditis and improved following surgery.
Assuntos
Ecocardiografia , Pericardite Constritiva/diagnóstico por imagem , Derrame Pleural/diagnóstico por imagem , Adolescente , Feminino , Ventrículos do Coração/patologia , Humanos , Pericardite Constritiva/patologia , Derrame Pleural/patologiaRESUMO
A 7-year-old girl was admitted because of dyspnea on exertion and palpitations. Her symptoms had gradually worsened for the last 6 months. She had physical features of the Marfan syndrome. Transthoracic echocardiography showed an ascending aortic aneurysm, severe aortic regurgitation, and mildly dilated left ventricle. Because of marked aortic aneurysm and severe aortic regurgitation, the patient was treated with a beta-blocker and an angiotensin converting enzyme inhibitor. Surgery was refused by her parents. We describe here a child with Marfan syndrome in whom significant dilatation of the ascending aorta and severe aortic regurgitation is encountered and major cardiovascular complications of Marfan syndrome were reviewed.
Assuntos
Aneurisma Aórtico/diagnóstico , Insuficiência da Valva Aórtica/diagnóstico , Síndrome de Marfan/diagnóstico , Disfunção Ventricular Esquerda/diagnóstico , Anormalidades Múltiplas/diagnóstico , Anormalidades Múltiplas/tratamento farmacológico , Antagonistas Adrenérgicos beta/uso terapêutico , Inibidores da Enzima Conversora de Angiotensina/uso terapêutico , Aneurisma Aórtico/complicações , Aneurisma Aórtico/tratamento farmacológico , Insuficiência da Valva Aórtica/complicações , Insuficiência da Valva Aórtica/tratamento farmacológico , Criança , Ecocardiografia , Feminino , Humanos , Síndrome de Marfan/complicações , Síndrome de Marfan/tratamento farmacológico , Índice de Gravidade de Doença , Disfunção Ventricular Esquerda/tratamento farmacológicoRESUMO
A 70-year-old man was admitted with sudden onset of dyspnea, near syncope and left hemiparesis. Clinical examination, blood gas analysis, ECG and the chest X-ray were consistent with pulmonary embolism. Transthoracic echocardiography (TTE) revealed right atrial free-floating thrombus, large atrial septal defect (ASD), right heart enlargement and pulmonary artery hypertension. Anticoagulation therapy was initiated immediately, soon after thrombolytic therapy was started but the patient died due to possible pulmonary or cerebral embolization. We underscore rapid diagnosis by TTE that revealed right heart thrombus in transit and large ASD.
Assuntos
Trombose Coronária/diagnóstico por imagem , Comunicação Interatrial/diagnóstico por imagem , Embolia Intracraniana/etiologia , Embolia Pulmonar/etiologia , Idoso , Trombose Coronária/complicações , Ecocardiografia , Evolução Fatal , Comunicação Interatrial/complicações , Humanos , MasculinoRESUMO
A 53-year-old man with a history of repair of atrial septal defect 3-months ago by primary suture was admitted to an emergency department with sudden onset chest pain and dyspnea. Transthoracic echocardiography revealed a large and mobile thrombus attached to the right side of the interatrial septum. The chest X ray and perfusion lung scan established the diagnosis of the multiple pulmonary emboli. Doppler examination of the venous system for a possible source of thrombus was unremarkable. The postoperative early appearance of thrombus and multiple pulmonary emboli defects at lung scan supported that thrombus was originated from the primary suture site. Thrombolytic treatment achieved complete resolution of the thrombus both in the pulmonary artery and at the repaired septal defect site. The patient was placed on warfarin and thrombus was not detected by transesophageal echocardiography at the 9-month follow-up.
Assuntos
Ecocardiografia , Fibrinolíticos/uso terapêutico , Cardiopatias/etiologia , Comunicação Interatrial/cirurgia , Embolia Pulmonar/etiologia , Estreptoquinase/uso terapêutico , Suturas/efeitos adversos , Trombose/etiologia , Anticoagulantes/uso terapêutico , Cardiopatias/diagnóstico por imagem , Cardiopatias/tratamento farmacológico , Humanos , Masculino , Pessoa de Meia-Idade , Embolia Pulmonar/tratamento farmacológico , Terapia Trombolítica , Trombose/diagnóstico por imagem , Trombose/tratamento farmacológico , Varfarina/uso terapêuticoRESUMO
Cardiac hydatid cyst is life threatening but rare. It is usually asymptomatic and has potentially lethal complications, so early diagnosis with definitive treatment is life-saving. In the present article, we report two cases. The first is a 30-year-old woman with a primary large multivesicular hydatid cyst in the left ventricle. The second is a 17-year-old woman who had multivisceral involvement with a cardiac hydatid cyst, a congenital cardiac anomaly that was an atrial septal defect complicated by pulmonary hypertension. 2-D echocardiography and magnetic resonance imaging confirmed the diagnosis. Surgical treatment was performed using extracorporeal circulation and adjunctive albendazol therapy.