Intracardiac extension of malignant uterine tumors. Echocardiographic detection and successful surgical resection.

The echocardiographic findings of two unusual cases of malignant uterine tumors that invaded the heart are reported. A woman previously operated on for invasive cervical carcinoma had multiple embolic phenomena and evidence of obstruction to mitral flow. An echocardiogram showed a mass in the left atrium that reached the mitral valve ring. The tumor was implanted in a pulmonary vein and was removed with no complications. Cell type indicated metastatic carcinoma of the cervix. In the second case the patient had a large abdominal mass and precordial manifestations of obstruction and regurgitation of the tricuspid valve. An echocardiogram showed that a mass emanating from the inferior vena cava filled the right atrium and part of the right ventricle. The trajectory of the tumor was followed to its origin in an ovarian vein by tomography. The entire tumor was removed and identified as endometrial stromal sarcoma. An increase in operations with or without radiation therapy for malignant tumors has augmented the frequency of metastatic invasion of the heart; intracavitary extension tends to results from embolization or propagation along great veins. This is the first report of a uterine carcinoma reaching the heart by way of the pulmonary veins and of invasion of the heart by endometrial stromal sarcoma, both with successful excision.

[Diagnosis of constrictive pericarditis and restrictive cardiomyopathy by pulsed Doppler echocardiography]. / Diagnóstico por ecocardiografía con Doppler pulsado de pericarditis constrictiva y miocardiopatía restrictiva.

Characteristics of flow through atrioventricular valves were analyzed by pulsed Doppler echocardiography (PDE) in 7 patients with either constrictive pericarditis or restrictive cardiomyopathy and 10 controls to determine the value of this technique in their differentiation. All patients were admitted with systemic venous congestion and underwent right and left heart catheterization. PDE variables considered included peak flow velocity (PV), acceleration time, peak velocity of the atrial component (PVA), PVA/PV quotient, duration of early diastolic fillings, deceleration of early diastolic filling, duration of diastolic flow and mean temporal velocity. Ventricular filling differed between patients and controls in that the former group was characterized by higher PV's, lower PVA's, higher deceleration and lower PVA/PV quotient. When we compared both patient groups we found a significant tendency toward higher PV's, faster deceleration and lower PVA/PV quotient in constrictive pericarditis.

[Applications of color-coded Doppler 2-dimensional echocardiography]. / Aplicaciones de la ecocardiografía bidimensional con Doppler codificado en color.

Conventional Doppler techniques have been used for sometime, but are limited by personal skill and experience, as well as by the fact that it can sample only one specific cardiac site at a time. The introduction of color-coded Doppler flow imaging systems allows by using multiple sample volumes an immediate display of intracardiac blood flow, spatially-oriented and super-imposed in two-dimensional echocardiography images, that not only increase temporal resolution, but which integrates anatomic and functional analysis. Likewise, the objective visualization of abnormal jet lesions permits the application of continuous-wave Doppler echocardiography with a high veracity for derived pressure gradients. Color-coded Doppler echocardiography emerges as the most promising, simple and non-invasive technique for obtaining confident quantitative information in diverse cardiac pathologic conditions and research.

Two-dimensional echocardiography and color Doppler imaging in patients with systolic-diastolic murmurs.

Characteristics of color-coded Doppler imaging combined with two-dimensional and M-mode echocardiography in six patients with systolic-diastolic murmurs are reported. PDA, congenital absence of pulmonary valve leaflets, ventricular septal defect and aortic regurgitation, two ruptured aneurysms of sinus of Valsalva, and a coronary fistula were identified and findings were corroborated in cardiac catheterization and/or surgery. Color-coded Doppler imaging increases the information of the echocardiographic method in differential diagnosis of these entities by characterizing flow in cardiac chambers more completely and by facilitating detection of associated defects.

[Left ventricular hypertrophy simulating an intracavitary tumor. Echocardiographic diagnosis]. / Hipertrofia ventricular derecha que simula un tumor intracavitario. Diagnóstico ecocardiográfico.

We report a case of a 14 month old infant with severe stenosis of the pulmonary valve in whom the angiographic image suggested the presence of a right ventricular (RV) tumor mass. The patient was admitted because of clinical manifestations of heart failure. Right heart catheterization demonstrated a transvalvular pulmonary gradient and filling defects in the infundibulum compatible with an intracavitary mass. Two dimensional and Doppler echocardiography confirmed pulmonary stenosis and showed that the mass corresponded to hypertrophy of the anterior RV wall. The combination of two dimensional and Doppler echocardiography are the indicated techniques in differential diagnosis of RV tumor masses and RV hypertrophy secondary to severe pulmonary valve stenosis.

[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.

[Echocardiography and trivalvular infectious endocarditis in a heart without apparent previous cardiopathy]. / Ecocardiografía y endocarditis infecciosa trivalvular en corazón sin aparente cardiopatía previa.

The echocardiographic findings in a patient with infective endocarditis are reported. There was involvement the aortic, mitral, and tricuspid valves. The heart had no previous valvular disease. The M-Mode and two dimensional studies, showed presence of vegetations in the aortic, mitral, and tricuspid valves. We consider that the echocardiogram allows the detection of endocarditis in its early stage.