[Cardiac metastasis of Grawitz tumor: transesophageal monitoring of the effectiveness of antineoplastic therapy]. / Metastasi cardiache di tumore di Grawitz: monitoraggio con ecocardiografia transesofagea dell'efficacia del trattamento antiblastico.

A patient with carcinoma of the kidney and right heart metastasis is reported. Transesophageal echocardiography allowed to detect the cardiac metastasis and to control the efficacy of antineoplastic therapy. The surgical resection of the primitive tumor was subsequently possible.

[Dobutamine echocardiography and positron emission tomography in the assessment of viable myocardium after a thrombolized acute myocardial infarction. Comparison with spontaneous recovery]. / Test ecodobutamina e tomografia and emissione di positroni nella identificazione del miocardio vitale dopo un infarto miocardico acuto trombolisato. Confronto con la ripresa funzionale spontanea.

BACKGROUND: Aim of the present study was to compare the ability of low-dose (5-10 gamma/Kg/min) dobutamine echocardiography (DE) and of positron emission tomography (PET), performed after a thrombolized acute myocardial infarction (AMI), to predict the spontaneous functional recovery (SFR) of viable but akinetic myocardial segments. PATIENTS AND METHODS: Twenty-one pts were studied by DE, 10 +/- 2 days (DE1) and 31 +/- 2 days (DE2), after a thrombolized AMI, and by PET (18F-FDS, glucose load) within 7 days after DE2; a basal echo was also performed 3 months after AMI. The left ventricle was divided in 16 segments, both in echo and PET examination. DE viability was defined as improvement in wall motion of akinetic seg; PET viability was defined as an FDG uptake > or = 40% of the maximum. RESULTS: In the 89 akinetic segments, DE1, DE2 and PET, respectively, identified, 16, 27 and 60 viable segments; the concordance with PET, in viable and not viable segments, resulted of 50% for DE1 and of 62% for DE2. After 3 months 29/89 segments had a SFR. In comparison with SFR the sensitivity of DE1 and DE2 was lower (51% and 68%) than PET (89%); the specificity was higher for DE1 and DE2 (98% and 96%) respect to PET (43%). CONCLUSIONS: In comparison with DE performed 10 days after a thrombolized AMI, DE performed 30 days after AMI revealed a greater extension of viable myocardium and a greater diagnostic accuracy in predicting SFR of akinetic segments. The concordance between DE and PET is high, if all myocardial segments are considered, and lower, if only akinetic segments are considered; in fact, PET identifies, as viable, a greater number of segments. In comparison with SRF, DE revealed the greatest specificity and PET the greatest sensitivity.

[Hemopericardium caused by cardiac perforation during anticoagulation therapy. Description of 2 cases]. / Emopericardio da perforazione cardiaca in corso di terapia anticoagulante. Descrizione di due casi.

We describe two cases of cardiac tamponade following a right ventricular wall perforation, due to temporary stimulating catheter, during acute myocardial infarction. The pericardial effusion, which occurred after the catheter remotion, could have been favoured by the anticoagulant treatment.

[Post-infarction rupture of the interventricular septum. A report on 2 cases studied by color-coded Doppler]. / Rottura post-infartuale del setto interventricolare. Descrizione di due casi studiati con Doppler a codice di colori.

Rupture of interventricular septum is an infrequent but serious complication of acute myocardial infarction. We report the cases of two patients admitted to our department for acute myocardial infarction whose clinical course was complicated by rupture of the interventricular septum. They died from cardiogenic shock on the 13th and 6th days. Two dimensional and color coded echocardiography correctly detected the presence and the site of the rupture.

[Aneurysm of the thoracic aorta as a cause of heart failure. Description of a case]. / Aneurisma dell'aorta toracica come causa di scompenso cardiaco. Descrizione di un caso.

The Authors describe the case of a 81 year old patient admitted to their department for cardiac failure. The patient was submitted to chest x-ray, bidimensional and Doppler echocardiography and computerized tomography. These exams identified the presence of an enormous aneurysm of thoracic and abdominal aorta. Intraluminal thrombus was present. The aneurysm compressed the left atrium and obstructed diastolic filling of left ventricle. Because of the poor conditions of the patient, surgery was not taken in account.

[Cardiac angioma. A case report and review of the literature]. / Angioma cardiaco. Presentazione di un caso e revisione della letteratura.

We report the case of a 4-year old child who underwent echocardiographic examination which revealed a multicystic tumor mass involving the infero-lateral wall of the left ventricle. It was necessary to perform a biopsy to make a reliable diagnosis. Histological studies indicated haemangiomatous and fibrous tissue of benign origin. The extensive involvement of the left ventricular free wall did not favour resection so we advised periodic clinical examination and Holter ECG to highlight any eventual occurrence of hypo or hyperkinetic arrhythmias.