A 61-year-old woman with a history of rheumatic valvular heart disease and permanent atrial fibrillation (AF), chronically anticoagulated with rivaroxaban, presented with acute ischemic stroke and bilateral upper-limb ischemia. Neuroimaging revealed an acute infarction in the right middle cerebral artery territory and a subacute infarction in the left posterior cerebral artery territory (). Doppler ultrasound confirmed arterial occlusion in both upper limbs (). Transesophageal echocardiography demonstrated marked left atrial (LA) enlargement, dense spontaneous echocardiographic contrast within the left atrial appendage […]

Introduction Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis constitute a group of systemic small-vessel inflammatory diseases characterized by pauci-immune necrotizing vasculitis and multisystem involvement, including granulomatosis with polyangiitis (GPA), eosinophilic granulomatosis with polyangiitis (EGPA), and microscopic polyangiitis (MPA).– MPA is classically associated with rapidly progressive glomerulonephritis and alveolar hemorrhage, conditions that carry high morbidity and mortality when not promptly recognized and treated., In addition to predominant renal and pulmonary involvement, there is growing evidence that patients with ANCA-associated vasculitis have an increased […]

Abstract Severe aortic stenosis is a progressive clinical entity that has historically developed alongside descriptions of pathological anatomy, cardiovascular semiology, heart surgery, and percutaneous cardiovascular interventions. Indication for valve replacement in patients with severe aortic stenosis is still based on symptom onset. With advances in surgical techniques, especially transcatheter implantation, the focus has shifted to identifying early markers of myocardial damage that may indicate irreversible myocardial injury. This review article seeks to provide a comprehensive analysis of methods for identifying […]

Introduction Assessment of the ascending aorta is an essential component of standard transthoracic echocardiography (TTE). While visualization of the aortic root and proximal ascending aorta is routinely achieved using the standard parasternal long-axis view (PLAX), imaging of the mid and distal ascending aorta remains technically challenging.– Current recommendations suggest moving the transducer to upper left intercostal spaces or alternatively using right parasternal windows to improve visualization of these segments in patients with adequate acoustic windows. In clinical practice, experienced echocardiographers […]

Abstract Background: Left ventricular ejection fraction (LVEF) measured by echocardiography is a widely used parameter in clinical practice for the assessment of ventricular function. More recently, global longitudinal strain (GLS) has emerged as a complementary method, as has the assessment of LVEF by cardiac magnetic resonance (CMR). However, regional evidence evaluating the concordance among these three techniques remains limited. Objectives: To assess the concordance between echocardiographic and CMR measurements in patients treated at a cardiovascular clinic in the city of […]

Abstract The echocardiographic estimation of left ventricular (LV) filling pressures is a cornerstone in the assessment of heart failure, particularly in patients with heart failure with preserved ejection fraction (HFpEF). The 2016 American Society of Echocardiography/European Association of cardiovascular Imaging algorithm standardized this evaluation using key variables, but a substantial proportion of cases remained indeterminate in clinical practice. The recent update of the American guideline reorganized the approach into a hierarchical framework, incorporating age-related adjustments and formalizing the role of […]

Abstract Background: Traditional volumetric parameters have limitations in detecting subtle left ventricular (LV) systolic dysfunction. Global longitudinal strain (GLS) and myocardial work (MW) allow a more sensitive assessment of ventricular mechanics. Objectives: To evaluate changes in GLS and MW indices during isometric handgrip exercise compared with resting conditions. Methods: A total of 30 healthy individuals (29.3 ± 6.1 years; 50% male) were included in the sample. Echocardiography was performed at rest and during handgrip exercise (30%-40% of maximal strength). GLS, […]

Special considerations for the pediatric population, The pediatric perspective in cardio-oncology presents particular challenges, given that cardiotoxicity related to cancer treatment is not limited to an acute event, but represents a dynamic process that can interfere with myocardial growth and maturation over time. The vulnerability of the developing heart, associated with early exposure to potentially cardiotoxic therapies, confers a prolonged risk of progressive myocardial dysfunction. In this context, the use of more sensitive, reproducible, and integrated cardiovascular imaging strategies becomes […]

Abstract All patients who are candidates for transcatheter closure of an ostium secundum atrial septal defect (ASD) should undergo a detailed echocardiographic assessment using 2D transesophageal echocardiography (TEE) prior to the procedure. It is essential for a comprehensive analysis of interatrial septal anatomy and for determining defect eligibility for the procedure. The type, number, size, location and morphology of the ASD, as well as the quality of the surrounding septal tissue and its relationship with adjacent cardiac structures, should be […]

Abstract Echocardiographic assessment of mitral regurgitation (MR) is multiparametric and often challenging. The artifact known as splay has been described as an additional tool for estimating the severity of regurgitation. The term refers to a side-lobe artifact that forms a horizontal arc on color Doppler imaging. This same phenomenon can also be observed in other valvular heart diseases, such as aortic regurgitation. In 2020, Wiener et al. reported that splay was present in 81% of cases of significant MR, reaching […]