[Abnormalities of the interatrial septum associated with cerebral ischemia in young adults: Contribution of trans-oesophageal echocardiography]

About 40% of the mechanism of ischaemic stroke in young adults remains unclear. A paradoxical embolism associated with persistence of a patent foramen ovale and/or the presence of an atrial septal aneurysm are significantly more frequent in patients examined for ischaemic stroke of unknown cause than in control subjects. Was to evaluate the contribution of trans-oesophageal echocardiography to the diagnosis of abnormalities of the interatrial septum and to identify the role played by this condition in unexplained ischemic stroke. In 30 consecutive patients, trans-oesophageal echocardiography recording were made during a saline contrast study. Abnormalities of the interatrial septum was diagnosed in 23.3% cases. The proportion of patent foramen ovale was 10% [3 patients]; atrial septal aneurysm was detected in 6.6%[2 patients]. The prevalence of patent foramen ovale associated with atrial septal aneurysm was 6.6% [2 patients]. Transesophageal echocardiography with contrast appears to be an effective exam in diagnosis of abnormalities of the interatrial septum and our study was suggestive of their embolic nature

[Cardiac amyloidosis revealing multiple myeloma]

Amyloidosis is a rare disease characterized by an extracellular accumulation of a protein polysaccharide complex [Amyloid]. Cardiac involvement is considered as a major prognostic factor. We report the case of two women, hospitalized for heart failure. The diagnosis of cardiac amyloidosis was suggested by echocardiography left ventricular concentric hypertrophy and typical amyeloid infiltration with hyperechoic. shiny and granite-like aspect of the interventricular septum. The histological confirmation was obtained by gastric biopsy in the first case and biopsy of the salivary glands in the second revealing an amyloidosis AL. This cardiac amyloidosis was secondary to multiple myeloma: monoclonal Gammopathy with immunoglobulin Lambda in the first and Kappa in the second, and the presence of a plasmocyte infiltration in the sternal puncture. Amyloidosis is a rare pathology, the cardiac involvement is frequent in the type AL and can occur with or without clinical manifestations. Echocardiography should be systematic in patients with confirmed amyloidosis