[Usefulness of exercise echocardiography for the diagnosis of ischemic heart disease]. / Utilidad de la ecocardiografía de esfuerzo en el diagnóstico de la cardiopatía isquémica.

INTRODUCTION AND PURPOSE: The purpose was assessing the usefulness of exercise digitalized echocardiography for the diagnosis of ischemic heart disease. PATIENTS AND METHODS: Eighty-eight patients, with suspected artery coronary disease, underwent both a exercise echocardiography with treadmill Bruce protocol and a coronary arteriography, within a period less than 2 months, without changes in their clinical evolution. Fifty-eight patients shown significant coronary lesions (> or = 50%). RESULTS: The exercise echocardiography showed a high sensitivity (74%), significantly greater (p < 0.01) than exercise electrocardiography alone. The sensitivity was fixed by the level of exercise done, reaching 91% when submaximal exercise was achieved, and by the severity and extension of coronary disease, being of 68.5% for a single-vessel, 80% for two-vessel and 100% for three-vessel. The specificity was 87%, considering the lesions lesser than 50% as not significant, and it was 100% when the coronary arteries without disease were taken into account. CONCLUSIONS: Exercise echocardiography can be a rutinary method for the diagnosis of ischemic heart disease, and it shows a high sensitivity and specificity, greater than exercise electrocardiography alone.

[Coronary ostial stenosis after an aortic valve replacement diagnosed by transesophageal echocardiography]. / Estenosis de ostium coronario tras recambio valvular aórtico diagnosticado mediante ecocardiografía transesofágica.

We submit the case of a 75-year-old man that underwent aortic valve replacement whose preoperative coronary angiography showed lesion-free coronaries. Two months after surgery he began to feel rapidly progressing effort angina pectoris. Transesophageal echocardiography showed prosthetic normal function while allowing the study of the great coronary trunks. We observed the presence of a 50% stenosis at the ostium of the left coronary artery trunk due to the use of selective coronary cannulation to supply cardioplegia solution during valve replacement. A second coronary angiography confirmed this finding. Transesophageal echocardiography may be used as an initial diagnostic method when coronary ostial stenosis is suspected after aortic valve replacement.

[Aneurysm of the interauricular septum: an exceptional cause of late systolic click. Echocardiographic diagnosis]. / Aneurisma del tabique interauricular: causa excepcional de chasquido sistólico tardío. Diagnóstico ecocardiográfico.

A 54 years old patient was referred for echocardiographic study because of a non-ejective click, diagnosed as mitral valve prolapse syndrome. 2d and M mode ultrasonic study showed a normal mitral valve and atrial septum aneurysm. The pathogenic and echocardiographic features of the inter atrial septum aneurysms are discussed.