RESUMO
Cardiac cyst hydatic is a rare disease. Two cases with left and right ventricular involvement are presented that demonstrate the use of echocardiography in the diagnosis and during follow up of the disease.
Assuntos
Equinococose/diagnóstico por imagem , Ecocardiografia Transesofagiana , Cardiopatias/parasitologia , Ventrículos do Coração/parasitologia , Idoso , Feminino , Cardiopatias/diagnóstico por imagem , Ventrículos do Coração/diagnóstico por imagem , Humanos , Pessoa de Meia-IdadeRESUMO
Behçet's disease is a chronic multi-system disease presenting with recurrent oral and genital ulceration, and relapsing uveitis. Cardiac involvement is an extremely rare manifestation of this disorder. We report an unusual case of Behçet's disease characterized by a mural cardiac thrombi in the right atrium and right ventricle along with transient protein C and S deficiency.
Assuntos
Síndrome de Behçet/complicações , Cardiopatias/etiologia , Trombose/etiologia , Adulto , Função do Átrio Direito , Síndrome de Behçet/sangue , Síndrome de Behçet/cirurgia , Ecocardiografia , Cardiopatias/sangue , Cardiopatias/cirurgia , Humanos , Imunossupressores/uso terapêutico , Masculino , Deficiência de Proteína C/sangue , Deficiência de Proteína C/complicações , Deficiência de Proteína S/sangue , Deficiência de Proteína S/complicações , Trombose/sangue , Trombose/cirurgia , Disfunção Ventricular Direita/sangue , Disfunção Ventricular Direita/etiologia , Varfarina/uso terapêuticoRESUMO
BACKGROUND: Doppler echocardiography has recently revealed frequent occurrence of valvular (in particular mitral) regurgitation in dialysis (HD) patients. We hypothesized that this may be in part 'functional' and related to the cardiac dilatation which is also frequently present. Thus it would be possible to improve it by ultrafiltration. METHODS: Mitral and tricuspid regurgitation was detected in 21 haemodialysis patients who had cardiomegaly but no manifest cardiac failure. They were treated by intensified ultrafiltration sessions, as much as they could tolerate, while all antihypertensive drugs were stopped. Doppler echocardiograms were then repeated. RESULTS: Mitral regurgitation disappeared in 13 and tricuspid regurgitation in 14 patients, while lesser degrees of either of them persisted in seven. This was accompanied by decreases of body weight (5.4 +/- 2.7 kg) mean arterial pressure (125 +/- 15 to 95 +/- 11 mmHg), cardiothoracic index (from 0.57 to 0.47), and left atrial (28 +/- 4 to 22 +/- 3 mm/m2), left ventricular systolic (25 +/- 5 to 21 +/- 55 mm/m2) and left ventricular diastolic (31 +/- 5 to 27 +/- 5 mm/m2), and mitral annular diameters (19.4 +/- 2 to 16.6 +/- 2 mm/m2). Ejection fraction increased but remained below 50% in 11 patients. CONCLUSION: Most of the mitral and tricuspid regurgitations seen in HD patients are partly or completely functional, due to dilatation of the mitral annulus which is related to volume overload. A more aggressive approach, while discontinuing antihypertensive drugs can correct or improve many of them and also ameliorate cardiac function.
