sábado, 27 de outubro de 2012

BRE - Score ECG x fração de ejeção - Blog de Eletrocardiografia

Recentemente na sessão do Departamento de Imagem da SBC/Ba, discutimos a análise do BRE ao modo M e suas implicações na avaliação da fução sistólica do VE, na terapia de ressincronização ventricular, etc. Eis que Dr. Nestor Rodrigues publica este trabalho sugerindo um escore eletrocardiográfico para correlacionar parâmetros eletrocardiográfcos e a função ventricular esquerda.
 
 
 

Estenose Aórtica - Vc sabia? - by Fábio Soares

Interessante este estudo... Desde 1988, começaram a surgir trabalhos tentando encontrar outros sinais ecocardiográficos para avaliação da gravidade da estenose aórtica, que não análise exclusiva de gradientes. E o tempo de ejeção do ventrículo esquerdo, o quanto este influencia nos gradientes transvalvares?
Em tempos de "Paradoxal Low Flow Normal FE" aortic stenosis, vale uma lida neste artigo:

 
 
 
Este outro artigo de revisão, também toca no assunto. Em pctes com EAo e disfnção ventricular esquerda, existiriam dados ecocardiográficos que me sugiram sua real gravidade (moderada x grave), sem realizar o eco stress?
 
 
 


quarta-feira, 24 de outubro de 2012

Prolapso da Valva Tricúspide - by Fábio Soares


"As for MR, three types of tricuspid changes can be visualized: a billowing valve, a prolapsing valve and a flail tricuspid valve. Tricuspid prolapse is generally associated with mitral valve prolapse and is defined as a mid-systole posterior leaflet displacement beyond the annular plane. The coaptation line is behind the annular plane. Tricuspid prolapse most often involves the septal and anterior tricuspid leaflets. The most common phenotype of tricuspid prolapse is diffuse myxomatous degeneration (Barlow's disease). A flail tricuspid leaflet is observed when the free edge of a leaflet is completely reversed in the RA, usually as a consequence of ruptured chordae (degenerative TR, infective endocarditis, trauma)."


European Journal of Echocardiography (2010)  11, 307 - 332
  
"Tricuspid valve prolapse is an infrequent echocardiographic finding that is most commonly associated with mitral valve prolapse. When compared with patients exhibiting isolated prolapse of the mitral valve, patients with tricuspid valve prolapse are somewhat older individuals with a slightly higher frequency of neurologic symptoms, fatigue, weakness, supraventricular arrhythmias (especially atrial fibrillation) and skeletal deformities. Tricuspid valve prolapse may serve as a marker of more-diffuse connective tissue abnormalities, and its identification also should prompt an echocardiographic search for evidence of prolapse and regurgitation of the other heart valves."
1987;17(2):97-109. 
 
"Tricuspid valve prolapse has remained a poorly defined entity. Some authors have stated that prolapse isolated to the tricuspid valve has not been documented. This report contains three cases of isolated tricuspid valve prolapse including the first pathologically confirmed case. A review of worldwide literature including all reported cases of isolated tricuspid valve prolapse is also presented.Although signs and symptoms are similar to those found with mitral valve prolapse, tricuspid valve prolapse may occasionally be differentiated by auscultation. The diagnostic criteria of tricuspid valve prolapse are thoroughly discussed for each of the presently available invasive and noninvasive techniques. Right heart catheterization can define such prolapse but is invasive and requires meticulous technique. Two-dimensional echocardiography supersedes M-mode because of the superior spatial evaluation of the tricuspid leaflets in relation to the right atrium and ventricle. Multiple views including a long-axis view of the right ventricular inflow are often required. This parasternal echocardiographic window is often the only one which permits adequate visualization of the posterior leaflet. The pathologic findings of tricuspid valve prolapse are similar to those of mitral valve prolapse. This report concludes with a description of associated conditions. Severe tricuspid regurgitation has not been noted with tricuspid valve prolapse in the absence of superimposed disease, yet much remains undefined concerning the clinical significance of this condition."
Am Col Card 1985; 6(2) 475-481
 


sexta-feira, 19 de outubro de 2012

domingo, 14 de outubro de 2012

Sessão do DIC / Ba - by Fábio Soares

 
 
Sessão do Departamento de Imagem, realizada em 10.10.12
Em tempos de Strain, Speckle Tracking, 3D, 4D, ainda há espaço para o modo M?