[Primary mesothelioma of the pericardium. Report of 2 cases and review of the literature]. / Mesotelioma primario del pericardio. Comunicación de dos casos y revisión de la literatura.

We described two adult females with primary pericardial mesothelioma. There was not history of asbestos exposure. The clinical picture suggested pericardial constriction, with predominantly right sided heart failure. Anatomically; one case was of a nodular type, being the other diffuse. On histology both cases were of the fibrous type. The second case was less differentiated; it perforated the right atrial wall creating an intracavitary mass. A review of the literature is made.

[Acquired systemic arteriovenous fistulas. Experience of 33 cases]. / Fístulas arteriovenosas sistémicas adquiridas. Experiencia de 33 casos.

We analyzed 33 cases of Acquired Systemic Arteriovenous Fistulas (FAVSA) seen in the INC-ICH between 1945 and 1981. The most frequent causes were traumatic (gunshot and knife wounds) and iatrogenic (surgery). The most affected vessels were femoral, carotid, axillary and subclavian. The FAVSA produced a hyperkinetic hemodynamic syndrome of high output that frequently resulted in fistular cardiopathy. Fistular cardiopathy and heart failure became evident from 4 days to 31 years after the initial insult and was related to the magnitude of the arteriovenous shunt. The latter depended on the distensibility of the communicating ring (the development of perifistular fibrosis did not allow dilatation of the fistular opening). Heart failure was a result of the magnitude of the shunt, even when the patient was young with a healthy heart. A detailed traumatic or surgical history was extremely important in the diagnosis. Relevant physical signs included: bounding pulses, a wide pulse pressure, the presence of a continuous murmur and thrill, a positive Nicoladoni-Branham's sign with a decrease in the heart rate and an increase in systemic blood pressure when the FAVSA was compressed. The existence of the condition became suspicious when heart failure appeared otherwise unexplained by an obvious cardiac lesion. Other important signs included the development of distal venous insufficiency and the presence of a palpable pulsatile mass. Fistular cardiopathy was observed in 60% of the cases studied, although the ECG was normal in 33%; 73% had cardiomegaly which improved with correction of the FAVSA. The treatment is necessarily surgical and required the appropriate technique.

[Silent mitral stenosis (report of 8 cases)]. / Estenosis mitral "muda" (presentación de ocho casos).

We studied eight cases of mitral "mute" stenosis we had discovered through echocardiogram, and analysed its clinical behaviour, the various findings in exploration, and electrocardiographic, radiologic, phonomecanocardiographic and echocardiographic changes. We mention the most notable signs for the suspected diagnosis of this kind of stenosis and the importance they have in the alleviation of this illness--frequently a very severe one, through surgical treatment. When mitral stenosis is not recognized in time through a precise diagnosis, turns to be a potentially lethal illness a short time after being diagnosed as a pulmonary arterial hypertension. We highly recommend the use of echocardiography for the diagnosis of mitral "mute" stenosis, because it has proved to be a inocuous, easy to obtain and very sensible way of diagnosing.