RESUMO
Low QRS amplitude in V1, with relative three-to-fourfold or greater increase in V2, is considered an indirect sign of right atrium enlargement (Peñaloza-Tranchesi sign). We describe a patient with Peñaloza-Tranchesi sign caused by an ascending aortic aneurysm, with normalization of the QRS complex amplitude in V1 after aortic replacement.
Assuntos
Aneurisma da Aorta Torácica/diagnóstico , Aneurisma da Aorta Torácica/cirurgia , Bioprótese , Implante de Prótese Vascular/métodos , Prótese Vascular , Eletrocardiografia , Idoso , Meios de Contraste , Diagnóstico Diferencial , Ecocardiografia , Feminino , Humanos , Tomografia Computadorizada por Raios XRESUMO
BACKGROUND: Hepatopulmonary syndrome (HPS) is defined as an oxygenation defect induced by intrapulmonary vasodilation in patients with liver disease or portal hypertension. It is investigated in patients with liver cirrhosis and less frequently in those with portal hypertension without liver cirrhosis, as may occur in hepatosplenic schistosomiasis (HSS). OBJECTIVES: To investigate the prevalence of HPS in patients with HSS, and to determine whether the occurrence of HPS is influenced by concomitant cirrhosis. METHODS: We evaluated patients with HSS with or without concomitant liver cirrhosis. All patients underwent laboratory testing, ultrasound, endoscopy, contrast echocardiography, and arterial blood gas analysis. FINDINGS: Of the 121 patients with HSS, 64 were also diagnosed with liver cirrhosis. HPS was diagnosed in 42 patients (35%) and was more frequent among patients with concomitant liver cirrhosis than in those without cirrhosis (42% vs. 26%), but the difference was not significant (p = 0.069). HPS was more common in those with spider naevi, Child-Pugh classes B or C and high model for end stage liver disease (MELD) scores (p < 0.05 each). MAIN CONCLUSIONS: The prevalence of HPS was 35% in this study. The occurrence of liver cirrhosis concomitantly with HSS may have influenced the frequency of patients presenting with HPS.
