Association of pulmonary atresia with intact ventricular septum and aortic valve stenosis. Prenatal diagnosis

A rare association of pulmonary atresia with an intact septum was diagnosed through echocardiography in a fetus 32 weeks of gestational age. The diagnosis was later confirmed by echocardiography of the newborn infant and further on autopsy. The aortic valve was bicuspid with a pressure gradient of 81mmHg, and the right ventricle was hypoplastic, as were the pulmonary trunk and arteries, and the blood flow was totally dependent on the ductus arteriosus.Universidade Federal de São Paulo (UNIFESP) Escola Paulista de MedicinaUNIFESP, EPMSciEL

Multiple arterial anomalies in the newborn infant. Echocardiographic and angiographic diagnosis

Multiple arterial anomalies characterized by tortuosity and rolling of the pulmonary arteries and aorta were diagnosed on echocardiography in an asymptomatic newborn infant with a phenotype suggesting Ehlers-Danlos syndrome. These changes were later confirmed on angiography, which also showed peripheral vascular abnormalities. The electrocardiogram showed a probable hemiblock of the left anterosuperior branch, and the chest x-ray showed an excavated pulmonary trunk with normal pulmonary flow.Universidade Federal de São Paulo (UNIFESP) Escola Paulista de MedicinaUNIFESP, EPMSciEL

Patent ductus arteriosus and pulmonary artery endarteritis

We describe a seven year old girl with echocardiographic diagnosis of pulmonary artery endarteritis as a complication of a patent ductus arteriosus, confirmed at surgery. This case illustrates the necessity of complete surgical resection of the infectious source as a way to avoid other complications such as pulmonary embolismDescrevemos uma paciente de sete anos com diagnóstico ecocardiográfico e confirmação cirúrgica de endarterite de artéria pulmonar, citada como complicação da persistência do canal arterial e ilustramos a necessidade de ressecção cirúrgica completa do processo infeccioso para evitar outras complicações, como embolia pulmonar.Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina (EPM)UNIFESP, EPMSciEL

Structural and functional characteristics of rat hearts with and without myocardial infarct. Initial experience with doppler echocardiography

OBJECTIVE: To assess by Doppler echocardiography the structural and functional alterations of rat heart with surgical induced extensive myocardial infarction. METHODS: Five weeks after surgical ligature of the left coronary artery, 38 Wistar-EPM rats of both sexes, 10 of them with extensive infarction, undergone anatomical and functional evaluation by Doppler echocardiography and then euthanized for anatomopathological analysis. RESULTS: Echocardiography was 100% sensible and specific to anatomopathological confirmed extensive miocardial infarction. Extensive infarction lead to dilatation of left ventricle (diastolic diameter: 0.89cm vs.0.64cm; systolic: 0.72cm vs. 0.33cm) and left atrium (0.55cm vs. 0.33cm); thinning of left ventricular anterior wall (systolic: 0.14cm vs. 0.23cm, diastolic: 0.11cm vs. 0.14cm); increased mitral E/ A wave relation (6.45 vs. 1.95). Signals of increased end diastolic ventricle pressure, B point in mitral valve tracing in 62.5% and signs of pulmonary hypertension straightening of pulmonary valve (90%) and notching of pulmonary systolic flow (60%) were observed in animals with extensive infarction. CONCLUSION: Doppler echocardiography has a high sensitivity and specificity for detection of chronic extensive infarction. Extensive infarction caused dilatation of left cardiac chambers and showed in Doppler signals of increased end diastolic left ventricular pressure and pulmonary artery pressure.Universidade Federal de São Paulo (UNIFESP) Escola Paulista de MedicinaUNIFESP, EPMSciEL

Echocardiograph pulmonary venous flow patterns in congenital heart defects with increased pulmonary flow

OBJECTIVES: To describe pulmonary venous flow patterns using transthoracic echocardiograms on children suffering from different congenital heart defects with increased pulmonary flow. METHODS: Prospective study and consecutive selection of children suffering from congenital heart defects with increased pulmonary flow. The transthoracic, apical view, Doppler echocardiogram was used, positioning the sample-volume at the lower pulmonary vein, 4mm from its junction with the left atrium. The data analyzed included: dominant systolic or diastolic pulmonary venous flow and atrial contraction waveform characteristics, designated as A for absent and R for reversed. RESULTS: The study included twenty-nine patients with a mean age of 29.9 ± 58.9 months, suffering from the following congenital heart conditions: interatrial and interventricular communication defects, patent ductus arteriosus, atrioventricular septal defects, total transposition of the great arteries and truncus arteriosus. All the patients presented a continuous pattern of high velocity pulmonary venous flow. Nine patients presented a dominant systolic waveform (31%), eighteen presented a dominant diastolic wave form (62%) and 2 patients had systolic and diastolic wave forms of equal amplitude (7%). Six patients (21%) presented a R atrial contraction waveform and 23 (79%) presented an A atrial contraction waveform. CONCLUSION: Congenital heart diseases with increased pulmonary flow present a continuous pattern of high velocity pulmonary venous flow with alterations mainly in the atrial contraction reversal pattern.OBJETIVOS: Descrever os padrões do fluxo venoso pulmonar com ecocardiograma transtorácico em crianças com diferentes malformações cardíacas congênitas com hiperfluxo pulmonar. MÉTODOS: Estudo prospectivo, de seleção consecutiva de crianças com malformações cardíacas congênitas com hiperfluxo pulmonar. Foi utilizado ecocardiograma Doppler transtorácico, plano apical, posicionando-se a amostra de volume na veia pulmonar inferior esquerda a 4 mm da sua junção com o átrio esquerdo. Os dados analisados foram: predomínio sistólico ou diastólico do fluxo venoso pulmonar, bem como as características da onda de contração atrial, sendo denominada A quando ausente e R quando reversa. RESULTADOS: Foram incluídos 29 pacientes, com idade média de 29,9±58,9 meses, com as seguintes malformações congênitas: comunicações interatrial e interventricular, persistência do canal arterial, defeito septal atrioventricular, transposição completa das grandes artérias e truncus arteriosus. Em todos, o fluxo venoso pulmonar apresentou um padrão contínuo, de maior velocidade, com predomínio da onda sistólica em 9 (31%) pacientes, diastólica em 18 (62%), e com igual amplitude em 2 pacientes (7%). A onda de contração atrial foi R em 6 pacientes (21%) e A em 23 (79%) pacientes. CONCLUSÃO: Nas doenças cardíacas congênitas com hiperfluxo pulmonar o fluxo venoso pulmonar apresenta um padrão contínuo, de alta velocidade, com alterações, principalmente no padrão reverso da contração atrial.Universidade Federal de São Paulo (UNIFESP)Universidade Federal de AlagoasUNIFESPSciEL

Trajetórias da Educomunicação nas Políticas Públicas e a Formação de seus Profissionais

Esta obra é composta com os trabalhos apresentados no primeiro subtema, TRAJETÓRIA – Educação para a Comunicação como Política pública, nas perspectivas da Educomunicação e da Mídia-Educação, do II Congresso Internacional de Comunicação e Educação. Os artigos pretendem propiciar trocas de informações e produzir reflexões com os leitores sobre os caminhos percorridos, e ainda a percorrer, tendo como meta a expansão e a legitimação das práticas educomunicativas e/ou mídia-educativas como política pública para o atendimento à formação de crianças, adolescentes, jovens e adultos, no Brasil e no mundo

CHAGAS CARDIOMYOPATHY AND CAPTOPRIL

BETH ISRAEL MED CTR,DIV CARDIOL,1ST AVE & 16TH ST,8TH DAZIAN,NEW YORK,NY 10003ESCOLA PAULISTA MED SCH,DIV CARDIOL,BR-04023 SAO PAULO,BRAZILESCOLA PAULISTA MED SCH,DIV CARDIOL,BR-04023 SAO PAULO,BRAZILWeb of Scienc

Evaluation of Left Ventricular Diastolic Function by Echocardiography with Tissue Doppler in Systemic Sclerosis

<div><p>Abstract Background: Systemic sclerosis (SS) is a connective tissue abnormality characterized by fibrosis of the skin and internal organs. Cardiac involvement with consequent myocardial dysfunction in SS is associated with increased morbidity and mortality. Objective: To investigate the left ventricular (LV) diastolic function in patients with SS and preserved systolic function. Methods: Patients with SS were evaluated with two-dimensional echocardiography with tissue Doppler for analysis of chamber diameters, LV mass index (LVMI), indexed left atrial volume (iLAV), systolic function of both ventricles, and presence and degree of diastolic dysfunction (DD). Results: We evaluated 50 patients, divided according to the presence of DD into Group 1 (n = 25; normal diastolic function, E/A ratio ≥ 0.8, deceleration time [DT] > 150 ms and < 200 ms, and septal e’ > 8 cm/s) and Group 2 (n = 25; with DD, subdivided into type I DD [E/A < 0.8, DT > 200 ms], type II [E/A ≥ 0.8, septal e’ < 8 cm/s, iLAV > 34 mL/m2], and type III [E/A > 2, DT < 150 ms, septal e’ < 8 cm/s]). Type I DD was the most frequent (34%), followed by type II DD (16%). LVMI and iLAV were similar in both groups, but septal and lateral e’ were reduced only in Group 2. In Group 2, we observed that patients with moderate DD had longer disease duration (p = 0.02). Conclusion: The prevalence of type I DD was elevated in SS and associated with aging. Disease duration emerged as an important factor in moderate DD.</p></div

Right coronary artery fistula with congestive heart failure in the neonate. Doppler echocardiographic diagnosis and closure with detachable balloon

We report here a case of coronary artery fistula in a neonate with clinical signs of heart failure. The electrocardiogram showed signs of left ventricular hypertrophy and diffuse alterations in ventricular repolarization. Chest X-ray showed an enlargement of the cardiac silhouette with an increase in pulmonary flow. After echocardiographic diagnosis and angiographic confirmation, closure of the fistulous trajectory was performed with a detachable balloon with an early and late successful outcome