[Localization of the point of origin of the pre-excitation wave of type A Wolff-Parkinson White syndrome by echocardiography]. / Localización del sitio origen de la onda de pre- excitación en el síndrome de Wolff-Parkinson- White de tipo A, utilizando el ecocardiograma.

The echocardiographic findings in two patients with type A Wolff-Parkinson-White syndrome with pre-excitation localized at the anterior left ventricular wall are reported. The M-mode echocardiogram demonstrated premature anterior systolic motion of the postero-basal left ventricular endocardium that preceded the normal systolic contraction of the left ventricle. Despite the fact that the bundle of Kent reaches the epicardium of the left ventricular wall and that ventricular contraction probably begins at the subepicardial surface, the echocardiographic observations of the premature contractions were limited to the subendocardial layers.

[Value of echocardiography in the diagnosis of myxoma of the left auricle]. / Valor de la ecocardiografía en el diagnóstico del mixoma de la aurícula izquierda.

We have been able to differentiate the right pre-operatory diagnosis of mixoma in the left auricle versus "tumor" caused by hypertrophy and fusion of the papillary muscles of the left ventricle in a severe mitral stenosis. In the mixoma we find the echoes only in the ventricular diastole and not in the sistole; there is a place without echoes in the protodiastole--which has a diagnosis value, and sometimes in the telediastole. When it is a "tumor" in the fusioned papillary muscles of the left ventricle, echoes can be found in ventricular diastole and sistole and there are not spaces without echoes in the protodiastole as it is usual in the pedicled tumors of the left auricle. We have found a new sign to predict the existence of a tumor in the left auricle instead of a mitral stenosis; if we find echoes in the left auricle during the ventricular sistole, we will observe that the front edges of the waves form a capital W, and the back ones form a small w. In the central portions of both ws, the waves go forward as it should happen in the mitral valve when existing a real mitral stenosis. Nevertheless, as this central portion is surrounded by a space without echoes, it means that the tumor is a pedicled one, constitutes an obstruction and is causing similar signs to those pertaining to the mitral stenosis.

[Vegetations of the mitral valve and the mitral prosthesis in patients with subacute bacterial endocarditis. Echocardiographic diagnosis]. / Vegetaciones de la válvula mitral y de la prótesis mitral en un paciente con endocarditis bacteriana subaguda. Diagnóstico ecocardiográfico.

In a patient with SBE in three differents ocassions in a period approximately of 9 months, the mitral valve was replaced on two occasions. The echocardiogram detected vegetations on two ocassions. The diagnosis of vegetation at the level of the mitral valve, was done for the first time in our hospital by this method. During the last admission, the echocardiogram suggested a vegetation at the level of the artificial mitral valve, projecting into the left atrium with the systole. This was confirmed by surgery.

Echocardiography of ventricular septal movement in Wolff-Parkinson-White syndrome.

Four patients, three with type B Wolff-Parkinson-White Syndrome and right ventricular preexcitation and one with type A Wolff-Parkinson-White Syndrome with left ventricular preexcitation, were studied echocardiographically. One of the patients with type B Wolff-Parkinson-White Syndrome was also studied while in intermittent normal conduction and right ventricular posterior preexcitation. Three patients with right ventricular preexcitation demonstrated early posterior systolic ventricular septal motion shortly after the on set of the delta wave of the QRS complex and later systolic paradoxic ventricular septal motion. During normal conduction in the patient with intermitten right ventricular preexcitation the early systolic posterior septal movement disappeared and the later systolic septal movement became posterior; ventricular septal systolic movement became normal. The type a Wolff-Parkinson-White Syndrome patient demonstrated normal systolic ventricular septal movement while in preexcitation.

Echocardiography of ventricular septal movement in left bundle branch block with left ventricular diastolic overload.

Four patients with left bundle branch block (LBBB) and left ventricular volume overload had sustained posterior ventricular septal systolic motion with no early septal posterior systolic motion. There was earlier than normal peak posterior septal systolic motion and earlier than normal anterior systolic septal motion. It is suggested that volume overload of the left ventricle alters ventricular septal motion in left bundle branch block.

[Echocardiographic diagnosis of valvular vegetations. Study of a case]. / El diagnóstico ecocardiográfico de vegetaciones valvulares Estudio de un caso

A case of a 23 year old patient with clinical manifestations of subacute bacterial endocarditis is presented, proven during the surgical treatment, in which it was possible to establish the diagnoses of a vegetation of the mitral valve through echocardiography. The echocardiographic changes produced by vegetations are analyzed and the technical defects which may lead to interpretation mistakes. It is concluded, that this non-ivasive method is of very usefull diagnozing the establishment of vegetations on the cardiac valves.