RESUMO
The electrocardiograms of a 69-year-old woman with severe heart failure showed a left-sided nonspecific intraventricular conduction delay (QRS duration, 0.13 seconds) characterized by notches and slurrings in the descending part of the R waves in the left precordial leads and in the ascending parts of the S waves in the right precordial leads. Subsequently, a complete right bundle branch block with wider QRS complexes (0.17 seconds) appeared. It is possible to consider that the left-sided nonspecific intraventricular conduction delay was concealed by the greater conduction delay occurring when the complete right bundle branch block was present. This would be in keeping with a previous study using Doppler tissue imaging in which this was postulated but where the corresponding electrocardiograms were not shown.
Assuntos
Arritmias Cardíacas/complicações , Arritmias Cardíacas/diagnóstico , Bloqueio de Ramo/complicações , Bloqueio de Ramo/diagnóstico , Eletrocardiografia , Disfunção Ventricular Esquerda/complicações , Disfunção Ventricular Esquerda/diagnóstico , Idoso , Diagnóstico Diferencial , Feminino , HumanosRESUMO
We describe a case of noncompaction of the ventricular myocardium diagnosed in the preoperative evaluation of a patient undergoing renal transplantation. Ventricular noncompaction is characterized by numerous prominent trabecular recesses with intratrabecular blood from the ventricular cavity. Color Doppler was suggestive of intramyocardial flow. With contrast-enhanced echocardiography the endocardial borders were clearly demarcated, allowing for visualization of trabecular recesses and intratrabecular flow. Contrast-enhanced echocardiography facilitates the diagnosis of noncompaction of the ventricular myocardium, circumventing the need for invasive diagnostic testing.
