Revista portuguesa de cardiologia : orgão oficial da Sociedade Portuguesa de Cardiologia = Portuguese journal of cardiology : an official journal of the Portuguese Society of Cardiology
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Adults with repaired tetralogy of Fallot (TOF) may be at risk for progressive right ventricular (RV) dilatation and dysfunction, which is commonly associated with arrhythmic events. In frequently volume-overloaded patients with congenital heart disease, tissue Doppler imaging (TDI) is particularly useful for assessing RV function. However, it is not known whether RV TDI can predict outcome in this population. ⋯ Our results suggest that TDI may detect RV dysfunction in patients with apparently normal function as assessed by conventional echocardiographic parameters. Reduction in RV early diastolic velocity appears to be an early abnormality and is associated with occurrence of arrhythmic events. TDI may be useful in risk stratification of patients with repaired tetralogy of Fallot.
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Advances in electrocardiography and enzymology in the 1940s and 1950s have provided better knowledge of the clinical evolution of myocardial infarction and recognition of the prognostic relevance of acute phase arrhythmias. This prompted the creation of intensive coronary care units in the subsequent decade. After the successful resolution of acute phase arrhythmias, it became clear that the myocardium necrotic area size was a determining factor in the long-term prognosis. ⋯ Myocardial reperfusion is a major accomplishment in this field. But it is like a double-edged sword because reperfusion injury significantly reduces the potential benefits of reperfusion. The huge amount of research undertaken in the past 20 years constitutes a paradigm of the relationship between experimental work and clinical practice, and has improved the prospects for diminishing infarct size, in both the short and long-term.
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Cor triatriatum sinistrum is a rare congenital cardiac anomaly in which the left atrium is divided into two compartments by a fibromuscular membrane. In most cases, the two cavities communicate through one or more openings. ⋯ The authors present four cases of cor triatriatum sinistrum diagnosed in different clinical contexts and age-groups. In all cases the diagnosis was based on echocardiographic findings (transthoracic and transesophageal) and was supplemented by other imaging modalities.
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Atrial septal defects (ASD) are among the most common congenital anomalies and account for 10% of congenital heart disease in the pediatric age-group and 30% in adults. Closure is indicated when there is evidence of hemodynamic significance or after a paradoxical embolic event. Ten years ago, percutaneous closure became the treatment of choice in our center for all patients with a clear indication and favorable anatomy. In this paper we report the experience of this first decade. ⋯ In this population the success rate was high and most of the complications were minor. The results of this collaboration between adult and pediatric cardiologists in the first ten years of activity confirm the safety and efficacy of percutaneous closure of septal defects, when there is careful patient selection and a standardized technique.
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Aortic valve stenosis can be complicated by gastrointestinal bleeding from angiodysplasia. A deficiency of high molecular weight multimers of von Willebrand factor (vWF) (type 2A von Willebrand disease) provides the link between this association, which is known as Heyde syndrome. Aortic valve replacement corrects the vWF abnormalities with long-term resolution of gastrointestinal bleeding. The authors present a case report and a review of this association.