To the editor: We present a male patient, 75 years old, admitted to our emergency room with right... more To the editor: We present a male patient, 75 years old, admitted to our emergency room with right arm pain for about an hour. The patient had only a history of arterial hypertension. On his physical examination, she had an irregular pulse. The right arm showed hypothermic with cyanotic hand. The right upper limb pulses were not palpable. Her initial electrocardiogram revealed atrial fibrillation with a fast ventricular response. Vascular ultrasound revealed complete occlusion of humeral right artery 2 cm distal to their origin. The patient was subjected to emergency upper limb angiography, and brachial embolus without flow on the right radial and cubital artery was found (Figure 1A). Crescent-shaped (meniscus sign) or multiple filling defects within an otherwise normal artery implicate an embolus (Figure 1B). Considering the clinical characteristics of the patient and the results of angiographic, the embolectomy was done with Fogarty catheter. After procedure, the patient showed no evidence of embolus and was found complete restoration of blood flow. Transesophageal echocardiography showed thrombus in left atrial appendix (Figure 1C). There was no evidence of valvular defects, intramural thrombi, aortic root pathology, vegetation’s or wall motion abnormalities.
The progress in noninvasive imaging techniques for aortic pathology, such as computed tomography ... more The progress in noninvasive imaging techniques for aortic pathology, such as computed tomography (CT), magnetic resonance (MRI) and transesophageal echocardiography (TEE) have facilitated the diagnosis and management of patients with aortic intramural hematoma (IMH). Despite incomplete understanding of their natural history, it is known there is no significant difference between the IMH and classic aortic dissection (AD) on the incidence of major complication or death. In this article, we present images of patient with type B aortic hematoma and different outcomes in their natural evolution.
Ebstein's anomaly (EA) is a rare congenital malformation, characterized by an apical displacement... more Ebstein's anomaly (EA) is a rare congenital malformation, characterized by an apical displacement and dysplasia of the septal leaflet of the tricuspid valve with a right ventricular atrialization compromising its function. This malformation includes electrical conduction abnormalities, and very rarely ventricular arrhythmias. We report the case of a 22-year-old male, presenting with dizziness and palpitations. The electrocardiogram showed a sustained monomorphic ventricular tachycardia (SMVT). The presentation of the disease with ventricular tachycardia associated with hemodynamic instability is extremely rare. We placed a surgical implantable cardiac defibrillator when the diagnosis of EA, SMVT, and right ventricular systolic impairment was confirmed.
To the editor: We present a male patient, 75 years old, admitted to our emergency room with right... more To the editor: We present a male patient, 75 years old, admitted to our emergency room with right arm pain for about an hour. The patient had only a history of arterial hypertension. On his physical examination, she had an irregular pulse. The right arm showed hypothermic with cyanotic hand. The right upper limb pulses were not palpable. Her initial electrocardiogram revealed atrial fibrillation with a fast ventricular response. Vascular ultrasound revealed complete occlusion of humeral right artery 2 cm distal to their origin. The patient was subjected to emergency upper limb angiography, and brachial embolus without flow on the right radial and cubital artery was found (Figure 1A). Crescent-shaped (meniscus sign) or multiple filling defects within an otherwise normal artery implicate an embolus (Figure 1B). Considering the clinical characteristics of the patient and the results of angiographic, the embolectomy was done with Fogarty catheter. After procedure, the patient showed no evidence of embolus and was found complete restoration of blood flow. Transesophageal echocardiography showed thrombus in left atrial appendix (Figure 1C). There was no evidence of valvular defects, intramural thrombi, aortic root pathology, vegetation’s or wall motion abnormalities.
The progress in noninvasive imaging techniques for aortic pathology, such as computed tomography ... more The progress in noninvasive imaging techniques for aortic pathology, such as computed tomography (CT), magnetic resonance (MRI) and transesophageal echocardiography (TEE) have facilitated the diagnosis and management of patients with aortic intramural hematoma (IMH). Despite incomplete understanding of their natural history, it is known there is no significant difference between the IMH and classic aortic dissection (AD) on the incidence of major complication or death. In this article, we present images of patient with type B aortic hematoma and different outcomes in their natural evolution.
Ebstein's anomaly (EA) is a rare congenital malformation, characterized by an apical displacement... more Ebstein's anomaly (EA) is a rare congenital malformation, characterized by an apical displacement and dysplasia of the septal leaflet of the tricuspid valve with a right ventricular atrialization compromising its function. This malformation includes electrical conduction abnormalities, and very rarely ventricular arrhythmias. We report the case of a 22-year-old male, presenting with dizziness and palpitations. The electrocardiogram showed a sustained monomorphic ventricular tachycardia (SMVT). The presentation of the disease with ventricular tachycardia associated with hemodynamic instability is extremely rare. We placed a surgical implantable cardiac defibrillator when the diagnosis of EA, SMVT, and right ventricular systolic impairment was confirmed.
Uploads
Papers by Rafael Porcile