[Arterial embolism. The detection of the central emboligenic source by transthoracic echocardiography. A study of 38 cases]. / Embolia arterial. Detección de fuente embolígena central mediante ecocardiografia transtorácica. Estudio de 38 casos.

38 cases with systemic embolism were studied with transthoracic echocardiography. Patients with previous history of neurologic manifestations or intermittent claudication were excluded. Only patients with good quality echocardiographic studies were included. The goals of the study were: to diagnose intracardiac masses responsible for the embolic episode and to evaluate the study as a guide for medical or surgical therapy in this group of patients in order to prevent new embolic events. In 9 patients an intracardiac mass was identified as responsible for the embolic event, 5 cases located in the left atrium, 2 cases of left ventricular thrombus, 1 case of left atrial myxoma and 1 case of marantic endocarditis. The later two were resected surgically and 3 cases of rheumatic mitral valve disease and 1 case of left ventricular aneurism were corrected surgically. It is concluded that transthoracic echocardiography is a valuable study in this patients not only as a diagnostic tool but as a guide to surgical and medical management.

[Risk of complete auriculoventricular block and cardiological complications in patients with bifascicular block undergoing general surgery]. / Riesgo de bloqueo auriculoventricular completo y complicaciones cardiológicas en pacientes con bloqueo bifascicular sometidos a cirugía general.

26 patients with bifascicular block defined as complete right bundle branch block and left anterior block diagnosed electrocardiographically according to Medrano's criteria, were studied to evaluate the indication for preoperatory pacemaker insertion due to the risk of complete A/V block, other cardiac complications were recorded carefully. 7 patients underwent a prophylactic insertion, due to associated first degree A/V block in 4 cases and in 3 cases due to symptomatic bifascicular block. No instance of complete A/V block was found in the study. The most severe complication recorded was in a patient who presented a myocardial infarction complicated with ventricular Tachycardia. The risk of complete A/V block is low and only a small group of this patients should be considered for a preoperatory pacemaker insertion due to associated risk factors.