[Influence of left ventricular hypertrophy on its function in essential arterial hypertension. Analysis by Doppler echocardiography]. / Influencia de la hipertrofia del ventrículo izquierdo sobre su función en la hipertensión arterial esencial, análisis por ecocardiografia Doppler.

In order to evaluate the influence of left ventricular hypertrophy (LVH) on the function of this ventricle, twenty patients with essential arterial hypertension (EAH) were studied using Doppler echocardiography. Patients with diastolic blood pressure greater than 91 mmHg were included. Antihypertensive treatment was stopped 2 weeks before the study. None of them had any concomitant coronary artery disease nor kidney involvement. Left ventricular diameters, left ventricular mass (LVM), stroke volume, fractional shortening, mean velocity of circumferential shortening (Vcfr), mean velocity of circumferential relaxation, mean velocity of aortic flow and mean E and A velocities of mitral flow as well as the ratio of these velocities (E/A) were measured or calculated. With those values from the entire group, arithmetic means were calculated and the population was divided into two groups: those with values greater than the mean and those with values below the mean for each variable for comparative purposes. The relationship of the individual values was also calculated. The interventricular septum thickness and the left ventricular end diastolic diameter were proportional with diastolic blood pressure (p less than 0.05). The LVM values shown an inverse relationship to the fractional shortening (p less than 0.01), Vcfr (p less than 0.05) as well as end diastolic diameter of left ventricle (r = -0.889, p less than 0.01) and with the stroke volume (r = -0.861, p less than 0.01). The E/A ratio was proportional to the fractional shortening (p less than 0.05) and to Vcfr (r = 0.903). The A velocity of the mitral Doppler flow showed an inverse proportion to the Vcfr (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

[Usefulness of 2-dimensional echocardiography in detecting intraventricular thrombi in patients with acute myocardial infarction]. / Utilidad de la ecocardiografía bidimensional en la detección de trombos intraventriculares en pacientes con infarto agudo del miocardio.

The purpose of this study is to determine the importance of two-dimensional echocardiography performed soon after admission to the coronary care unit to provide useful information concerning wall-motion abnormalities, and to detect and characterize left ventricular thrombi. A major goal is to identify a subgroup of patients with acute myocardial infarction who are at risk for systemic embolization; in this subgroup the benefits of anticoagulation treatment would theoretically outweigh the associated risks. We studied 7 consecutive male patients, age range from 32 to 60 years, with acute myocardial infarction. Five patients had antero-septal infarction, 1 anterolateral and another had anterior wall infarction. We performed two-dimensional echocardiography within the first week after admission. All patients had severe apical-wall-motion abnormalities (akinesis or dyskinesis) and left ventricular thrombi. All patients received anticoagulation therapy. Two-dimensional echocardiography, performed one month after the first study, showed that the thrombi had decreased in size in 6 patients and could not be visualized in 1 patient. The noninvasive nature of echocardiography allows serial evaluations of patients with known left ventricular thrombi and permits assessment of the effect of therapy.

[Diagnosis by two-dimensional and Doppler echocardiography of coronary aneurysm in a Mexican boy with Kawasaki disease]. / Diagnóstico con ecocardiografía bidimensional y Doppler de aneurisma coronario en un niño mexicano con enfermedad de Kawasaki.

The mucocutaneous lymph node syndrome or Kawasaki's disease, is a clinical entity consisting of high fever, mucocutaneous involvement and cervical lymphadenopathy that affects infants and young children. Although syndrome is predominantly found in Japan, it has become increasingly recognized in other countries. This disease appears to be benign and self-limited in most instances. However, extensive cardiac involvement may cause sudden death due to myocardial infarction from occlusive coronary artery disease, rupture of a coronary aneurysm or conduction abnormalities. As a result, it has become important to establish a noninvasive diagnostic method for assessing cardiac involvement in this disease. The purpose of this study is to describe the echocardiographic recognition of a left coronary artery aneurysm in a 3 years old mexican boy with Kawasaki's disease.

[Usefulness of M-mode echocardiography, two-dimensional and Doppler, in the study of pericardial diseases]. / Utilidad de la ecocardiografía modo M, bidimensional y Doppler en el estudio de las enfermedades del pericardio.

The objective of this communication is to determine utility of echocardiography M mode, two-dimensional and Doppler, in the diagnosis and follow-up of patients with pericardial disease. This procedure was used initially to the diagnosis of pericardial effusion, actually it has a lot of new applications. It's noninvasive and low cost, and would give us important information about our patients.

[Myocardial infarct without pathologic Q waves]. / Infarto del miocardio sin ondas Q patológicas.

Neither the presence nor the absence of pathological Q waves are related to the transmural or subendocardial localization of an acute myocardial infarction. The prognosis of an acute myocardial infarction without pathological Q waves is controversial. We studied 23 hospitalized patients with prolonged, typical chest pain, enzymatic elevation, an EKG without pathological Q waves but with changes in ventricular repolarization and a positive scintigraphy with radioactive pyrophosphates. The patients were classified in two groups according to the pattern of pyrophosphate uptake; group A had grade 2+ focal uptake (N = 13) and group B with grade 2+ diffuse uptake (N = 10). The level of serum glutamic transaminase was significantly greater in group A as compared to group B (p less than 0.05). However, levels of creatine kinase and lactic dehydrogenase were no different. The clinical hospital course was similar in both groups. Eleven patients were followed by 31.7 months: 30.4% had chronic angina, one underwent coronary bypass surgery, another suffered a recurrent myocardial infarction and there were no deaths. The diagnosis of acute myocardial infarction should be suspected in patients with prolonged angor pectoris, electrocardiographic changes in ventricular repolarization, increased enzymatic levels and a positive scintigraphy with a grade 2+ diffuse myocardial uptake of Tc 99m pyrophosphates. The diagnosis is certain if the uptake has a focal distribution.

[Echocardiographic recognition of endarteritis of the pulmonary artery in patent ductus arteriosus]. / Reconocimiento ecocardiográfico de endarteritis de arteria pulmonar en persistencia del conducto arterioso.

We described the echocardiographic signs of pulmonary endarteritis and the importance of Doppler study in three patients with patent ductus arteriosus. The diagnosis and follow-up of this complication with noninvasive study would avoid the exposure of the patient to danger of dislodging the vegetations with the catheter, during invasive procedures.