Displasia ventricular direita arritmogênica: diagnóstico, prognóstico e tratamento

Descritas as características anátomo-clinicas da displasia ventricular direita arritmogênica e discutidos os métodos diagnósticos e terapêuticos, é apresentada a Série de Maastricht constituída de 14 pacientes, com os dados clínicos, diagnósticos e terapêuticos num tempo médio de 4.2 anos de acompanhamento

Abdominal aortic aneurysm screening during transthoracic echocardiography in an unselected population

OBJECTIVE: We sought to investigate the echocardiographic prevalence of abdominal aortic aneurysm (AAA) in an unselected group of patients referred for regular transthoracic echocardiography (TTE). METHODS: Prospectively, during a 3-month period, a limited ultrasound examination of the infrarenal aorta was performed. AAA was defined as a diameter of 30 mm or more. RESULTS: The abdominal aorta could be visualized in 742 patients. The prevalence of AAA was 4.6%. AAA prevalence increased with age, especially in men. In 34 patients AAA was unknown and aortic diameters exceeded 50 mm in 4 patients. Two underwent elective but urgent operation. Patients with AAA were older and had an increased ascending aorta diameter, larger left ventricular dimensions, higher left ventricular mass index, and lower ejection fraction. CONCLUSION: AAA is prevalent in patients referred for regular TTE. Routine rapid screening of the abdominal aorta during TTE is beneficial and should, therefore, be part of a standard TTE examination for patients older then 50 year

Idiopathic atrial fibrillation patients rapidly outgrow their low thromboembolic risk:a 10-year follow-up study

Background Healthy atrial fibrillation (AF) patients will eventually outgrow their low thromboembolic risk. The purpose of this study is to compare the development of cardiovascular disease in healthy AF patients as compared to healthy sinus rhythm patients and to assess appropriate anticoagulation treatment. Methods Forty-one idiopathic paroxysmal AF patients (56 +/- 10 years, 66% male) were compared with 45 healthy sinus rhythm patients. Patients were free of hypertension, antihypertensive and antiarrhythmic drugs, diabetes, congestive heart failure, coronary artery or peripheral vascular disease, previous stroke, thyroid, pulmonary and renal disease, and structural abnormalities on echocardiography. Results Baseline characteristics and echocardiographic parameters were the same in both groups. During 10.7 +/- 1.6 years, cardiovascular disease and all-cause death developed significantly more often in AF patients as compared to controls (63% vs 31%, log rank p&lt;0.001). Even after the initial 5 years of follow-up, survival curves show divergent patterns (log rank p= 0.006). Mean duration to reach a CHA(2)DS(2)-VASc score&gt; 1 among AF patients was 5.1 +/- 3.0 years. Five of 24 (21%) patients with CHA(2)DS(2)-VASc&gt; 1 did not receive oral anticoagulation therapy at follow-up. Mean duration of over- or undertreatment with oral anticoagulation in patients with CHA(2)DS(2)-VASc&gt; 1 was 5 +/- 3.0 years. Conclusion The majority of recently diagnosed healthy AF patients develop cardiovascular diseases with a consequent change in thromboembolic risk profile within a short time frame. A comprehensive follow-up of this patient category is necessary to avoid over- and undertreatment with anticoagulants.</p