[A simplified method for estimating mitral valve area by Doppler]. / Método simplificado para la estimación del área valvular mitral por Doppler.

Based upon geometrical considerations we have developed a new method for estimation of valve area in patients with mitral stenosis. A special ruler enables us to read the valve area from the Doppler record. We prove that our new method is more precise and rapid than original Hatle's procedure. In 35 patients, we found a good correlation between the result of our method and the valve area obtained by 2D-Echo. Thus the new method is very useful for Doppler evaluation of mitral stenosis patients.

[Color-coded cardiac Doppler]. / Doppler cardíaco codificado en color.

Color flow mapping with Doppler technique was reviewed. We describe the advantages and technical was reviewed. We describe the advantages and technical limitations of the technique. The usefulness of color flow mapping in acquired and congenital disease was studied. We conclude that new information was added, concerning complex intracardiac flow, in order to the traditional study with classic continuous and pulsed Doppler examination.

[Echocardiographic aspects of false intraventricular tendons]. / Aspetti ecocardiografici dei falsi tendini intraventricolari.

A series of 4260 consecutive echocardiographic examinations, performed in 5 Cardiological Centers was examined, identifying 125 intraventricular false tendons (FTs) in 100 cases (55 normals and 45 with heart disease) of whom 31 were female and 69 male, aged 3 to 82 years. An anatomo-morphological study was possible in 9 cases, dead for stroke or heart failure, on autopsy, and in 7, on heart surgery. A phonocardiogram was performed in all normals and in 20 patients. On echocardiography, FTs appeared as an echo-producing string-like structure, straight between the septum and the ventricular free wall, mobile during the cardiac cycle, without systolic thickening and any relation with the atrioventricular valvular apparatus. The prevalence of FTs was 2.3%; it was 3.2% to 5.3% in younger people. FTs were located in the right ventricle (4 cases), left ventricle (95 cases) or in both (1 case). Their site was left apical (45 FTs), right apical (2 FTs), right (3 FTs) and left (20 FTs), upper septum-to-free wall (55 cases). In 1 case hypertrophy of trabeculae of the left ventricle was detected. FTs were single (79 cases), double (19 cases), multiple (2 cases), short (42 cases), long (58 cases), thick (45 cases) and thin (55 cases). They showed a membrane-like motion (thick FTs-45 cases) and a valve-like motion (thin FTs-55 cases). Innocent murmur was detected in 50 of 55 normals and related to thin FTs. Of 16 cases examined anatomically and histologically, FTs were fibrous in their distal portion and fibro-muscular in the proximal one in 12 cases, whereas they were entirely fibrous-muscular in 4 cases. The site and location of FTs detected by echo were confirmed by anatomy in all cases. In 4 cases other 9 FTs, not detected on echocardiography, were found. These data suggest that echocardiography is a useful tool to detect intraventricular FTs and differentiate them from other echo-producing structures. Although a relationship between FTs and heart disease has not been found, their presence could be responsible of innocent murmur in many normal subjects.

[Persistent left superior vena cava and rheumatic mitral valve stenosis studied with echocardiography]. / Vena cava superior izquierda persistente y estenosis mitral reumática estudiadas con ecocardiografía.

A case of persistent left superior vena cava associated with rheumatic mitral stenosis in a 27 year old woman is described. Comments are made of the echocardiographic findings of a space free of echos located at a level behind the back wall of the left ventricle, at a level of the mitral valve. Echocardiographic Mode and two-dimensional technics were used in the observation of this image. Other pathologies, in which is possible to obtain similar images are also discussed, as well as the value of using echocardiographic contrast studies in the differential diagnosis.

[Echocardiographic evaluation of ischemic cardiopathy]. / Valoración ecocardiográfica de la cariopatía isquémica

We studied a group of patients with ischemic heart disease divided into two groups: Group I coronary insufficiency. Group II myocardial infaction. We centered the work on the following aspects: analysis of the contractility; evaluation of the movement of the ventricular wall and of the septum; movement of the mitral valve; diagnosis of ventricular dyskinesias, akinesias, and hypokinesias. The patients in group I did not show significant alterations in the values of the ejection fraction and speed of circunferential shortening. The mean values of these parimeters are significantly less than the group of patients with infarcts, and 41% of these patients have EF less than 50% and Vcf less than 0.9. We did not find a correlation between these perimeters and the localization of the infarct. The velocity of the posterior ventricular wall was disminished in both groups of patients. The amplitude of movement of the posterior wall was reduced in the group of patients with infarctions. These parimeters were more altered in the posterior infarcts than in those with anterior localization and they are more an index of the state of the posterior wall than of the ventricular contractility considered overall, contary to mitral descriptions. In 3 cases of acute infarct we found paradoxical movement of the septum, which normalized itself in one patient in 6 months. In 6 other patients with old infarct we observed localized dyskinesias of the septum and of the free wall of the left ventricle. The mitral valve appears altered in a great proportion of coronary patients the most notorious characteristics being: a decrease in the EF pendent; an increase of the F index. These findings are considered in relation with the ventricular pressures and with the degree of distensibility of the left ventricle.

[Mechanism of electric alternance in pericardial effusion. Study with ultrasonics]. / El mecanismo de la alternancia eléctrica en el derrame pericárdico: estudio con ultrasonido

Two cases are presented, one with chronic renal failure and the other with a hepatic cyst perforated in the pericardium, with a tension pericardic leakage accompanied with by electrocardiographic alternance. After correct treatment, pericardiocentesis and surgery, respectively, the electrocardiogram lost its electric alternance. The echocardiogram evaluates the importance of the pericardic liquid volume which causes, because of the particular cardiac anatomy, an alternating movement of the heart within the pericardic sac. This factor would be decisive in the origen of the electric phenomenon, a fact corroborated when the electric alternance disappears after pericardiocentesis or surgery.