[Hemangioma of the right ventricular outflow tract, clinical report]. / Hemangioma da câmara de saída do ventrículo direito, a propósito de um caso clínico.

Cardiac hemangiomas are a rare benign primary tumor with an estimated incidence of no more than 10% of cases of primary cardiac tumors. They can arise in any location but most of them occur predominantly in the right ventricle. Heart hemangiomas are usually asymptomatic and accidentally diagnosed by imaging methods such as echocardiography or nuclear magnetic resonance; however they can cause symptoms resulting from obstruction of blood flow, interference with the heart valves, arrhythmias or embolization. Surgical resection is the treatment of choice and long-term prognosis is favorable after total resection of the tumor. The authors present a case of cardiac hemangioma whose clinical diagnosis was triggered by exertional dyspnea and culminating with complete resection of the tumor. In this context, a review of this entity is made with special emphasis on imaging modalities used for diagnosis.

Noncompaction of the ventricular myocardium: characterization and follow-up of an affected population.

Noncompaction of the ventricular myocardium (NVM) is a rare congenital disease caused by an arrest in normal myocardial embryogenesis, leading to persistence of numerous prominent trabeculations which communicate with the left ventricle. It was first described as a congenital condition affecting children, but several cases have been reported of late presentation, and recent studies suggest it may be underdiagnosed. The main clinical manifestations are congestive heart failure, arrhythmias (supraventricular or ventricular) and systemic embolism. We describe a series of twenty patients, focusing on clinical history, echocardiography and follow-up.

The threshold of human endurance: 60 years of a congenital heart defect.

Long term survival in patients with partial atrioventricular septal defect (PAVSD) without adequate surgical management is very rare. The authors present the case of a 60 year-old woman who was referred to our hospital with dyspnea and worsening of general condition. A heart defect was diagnosed at the age of 25 years, but at the time the patient declined surgery. The patient underwent echocardiographic and haemodynamic evaluation prior to corrective surgery. The present report highlights the complications of chronic volume overload due to a congenital cardiac defect characterized by left--to-right shunts and atrio-ventricular valvular regurgitation with its haemodynamic implications. Despite the haemodynamic burden, the patient underwent successful corrective surgery, demonstrating the resilience of human endurance facing various comorbidities.

Cardiac sarcoidosis: a case report.

Cardiac involvement is found in approximately 5% of patients with sarcoidosis. The course of the disease is variable, ranging from benign arrhythmias to high-degree heart block or sudden death, and diagnosis is difficult. Endomyocardial biopsy can confirm the diagnosis but the diagnostic yield of the procedure is low because of the uneven distribution of the granulomatous process. Cardiac sarcoidosis should be presumed in patients with known sarcoidosis who develop arrhythmias, conduction disease, heart failure or ECG abnormalities. The authors present a case report and brief review of cardiac sarcoidosis.

Brucella endocarditis--case report and literature review.

Endocarditis is a rare and serious complication of brucellosis and is the main cause of death in this pathology. Diagnosis requires a high level of suspicion and is based on the association of epidemiological, clinical and serological elements. Echocardiography plays a crucial role in early diagnosis, as well as in identifying predisposing heart disease and local complications typical of this pathology. Treatment is not consensual; most authors recommend an early surgical approach, due to the degree of tissue destruction caused by Brucella and the high rate of recurrence. Nevertheless, other authors stress the need for prognostic stratification of each case and support conservative treatment in low-risk cases. This article describes the case of a patient with brucella endocarditis that was treated medically and reviews the relevant literature.