Transthoracic Echocardiography (TTE) is a well-established tool for assessing cardiac function and hemodynamics. While Left Ventricular (LV) systolic and diastolic function are commonly used metrics, Cardiac Output (CO) remains central for evaluating hemodynamic status, especially in critical care settings. TTE-derived parameters, such as Left Ventricular Outflow Tract Velocity-Time Integral (LVOT VTI) and LVOT area, when combined with body habitus and heart rate, provide noninvasive estimates of cardiac output. However, the accuracy of CO calculations may decrease when multiple covariates are […]

Abstract Background Dyspnoea is a common clinical symptom that frequently prompts hospital admission and is associated with significant morbidity. While it most often results from prevalent cardiopulmonary conditions, rare congenital cardiovascular anomalies can also manifest with dyspnoea. Partial Anomalous Pulmonary Venous Connection (PAPVC) and Coronary Artery Fistulas (CAFs) are uncommon congenital malformations of the cardiovascular system, and their simultaneous presence is exceedingly rare. Early recognition of such anomalies is critical to avoid progressive hemodynamic compromise and to guide appropriate management […]

Introduction Aneurysms of the inferior vena cava (IVC) are a rare occurrence in the cardiovascular system and can present with a variety of signs and symptoms. In many cases, patients remain asymptomatic, which makes diagnosis difficult. Venous aneurysms are defined as an abnormal and persistent dilation of a vein in a specific area, with a diameter at least twice that considered normal. An IVC aneurysm is a specific type of venous aneurysm. This case report is relevant because this condition […]

Abstract A patient with severe, symptomatic hypertrophic cardiomyopathy (HCM) without a significant left ventricular outflow tract (LVOT) gradient at rest requires further evaluation. During exercise echocardiography (EE) performed on a supine bicycle, a latent or underestimated dynamic obstruction may be identified in real time, with postprandial assessment being particularly relevant.

Introduction Ebstein’s anomaly is a complex congenital heart disease that occurs in one out of every 200,000 live births. Its association with left-sided obstructive lesions is rare and poses significant challenges for both clinical and surgical management. In this case report, we present a newborn patient with Ebstein’s anomaly associated with supravalvular mitral stenosis and coarctation of the aorta (CoA), who underwent cardiac catheterization for the implantation of a post-dilatable stent in the aortic isthmus via the carotid approach. […]

Hypertrophic cardiomyopathy (HCM) has become the most common inherited myocardial disease, with an estimated global prevalence between 1:200 and 1:500. Despite its relatively high frequency in the general population, the disease remains significantly underdiagnosed. Only about 15% of affected individuals are clinically identified, due mainly to the wide variability of phenotypes and clinical manifestations., Slightly more than half of patients may develop progressive symptoms or experience adverse events throughout their lifetime. Early identification, risk stratification, and cardiovascular therapies and interventions […]

Introduction Over the past decade, nuclear cardiology has undergone a profound transformation.– What was once primarily a diagnostic tool focused on ischemia detection has evolved into a comprehensive platform for physiological understanding, risk stratification, and precision cardiovascular care.,- In this context, the field has shifted from simply identifying disease to elucidating its underlying mechanisms, echoing Marie Curie’s insight that “nothing in life is to be feared, it is only to be understood.” The year 2025 did not stand out for […]

Diastolic dysfunction (DD) remains a diagnostic challenge, not for lack of available parameters, but because uncertainty emerges when complex physiology is reduced to static labels in echocardiographic reports. In clinical practice, physicians are often less concerned with the specific grade of DD and more interested in its prognostic implications and in whether increased filling pressures may explain dyspnea, guide further investigation, and support therapeutic decisions. It is precisely in this variable, mean left atrial pressure (MLAP) and left ventricular (LV) […]

Introduction In recent years, we have witnessed a universal and unprecedented advancement of artificial intelligence (AI) across diverse medical scenarios, with a particularly relevant impact on diagnostic imaging, especially ultrasonography. Ultrasonography is a widely available, low-cost, real-time method with rapid image acquisition and no exposure to ionizing radiation. Despite these advantages, ultrasonography remains limited by its operator- and equipment-dependent nature, which contributes to significant interobserver and interinstitutional variability, in addition to hindering large-scale standardization., […]

Coronary CT Angiography (CCTA) has become established as a first-line test in the evaluation of chest pain, supported by robust evidence of prognostic impact, advances in Artificial Intelligence (AI), and technological evolution with photon-counting CT. Publications in 2025 reposition CCTA as a central platform for risk stratification and therapeutic guidance in coronary artery disease. The 10-year follow-up of the SCOT-HEART trial represents a major milestone in this process. Among 4,146 patients with stable chest pain randomized to standard care with […]

Abstract Background: Echocardiography plays a fundamental role in the diagnosis of cardiovascular diseases related to SARS-CoV-2 infection. Despite prior investigation in the literature, studies focusing on cardiovascular manifestations among patients from the Brazilian Legal Amazon region remain scarce. Objectives: To identify cardiovascular complications of COVID-19 in patients admitted to a hospital in the North Region of Brazil and their potential association with mortality. Methods: We conducted a retrospective cohort study including 25 medical records of adults diagnosed with COVID-19. These […]

Abstract Background: The Venous Excess Ultrasound (VExUS) score has been proposed as an ultrasonographic method for assessing systemic venous congestion in patients with acute decompensated heart failure (ADHF). However, the relationship between VExUS and the biomarker N-terminal pro-B-type natriuretic peptide (NT-proBNP) remains unclear in literature. Objectives: To evaluate the correlation between the VExUS score and serum NT-proBNP levels in patients with ADHF. Methods: This retrospective observational study included 117 patients hospitalized with ADHF. Systemic venous congestion was assessed using the […]

ABSTRACT Background: Surgical and transcatheter techniques represent the two principal approaches for atrial septal defect (ASD) closure. Although both are widely used, comparative evidence regarding their mid-term effects on cardiac remodeling and right ventricular (RV) function remains limited. Objectives: To compare mid-term cardiac structural remodeling and right ventricular functional recovery after surgical versus transcatheter ASD closure in pediatric patients using serial color Doppler echocardiographic assessment. Additionally, to determine whether either technique leads to faster or greater improvement in right heart […]

Abstract Background Conventional echocardiography often struggles to differentiate intracardiac masses, particularly in patients with poor acoustic windows. Contrast-enhanced Echocardiography (CEE) overcomes this limitation by visualizing perfusion patterns — distinguishing avascular thrombi from vascularized tumors. We aimed to synthesize existing evidence to evaluate the diagnostic accuracy of CEE. Objectives To evaluate the diagnostic accuracy of CEE for differentiating cardiac masses in adults, using histopathology as reference and reporting AUC, sensitivity, specificity, PPV, and NPV. Methods Systematic searches of PubMed, Web of […]

Abstract Background Identifying atrial etiology in patients with mitral regurgitation remains challenging because the diagnosis is often established by exclusion. The use of a multivariable model may enhance diagnostic accuracy in the context of atrial functional mitral regurgitation. Objective To develop and validate a multivariable logistic regression model based on clinical and echocardiographic characteristics to predict atrial functional mitral regurgitation. Methods This cross-sectional study included patients with significant mitral regurgitation diagnosed by transesophageal echocardiography. The dataset was randomly divided into […]

Abstract Takayasu arteritis (TA) is a rare large-vessel vasculitis that primarily involves the aorta and its major branches and predominantly affects women of reproductive age. We report the case of a woman who experienced an ischemic stroke at age 20 and a transient ischemic attack at age 53, with TA diagnosed only after the second cerebrovascular event. Although ischemic stroke is an uncommon initial manifestation of TA, early recognition and timely management are essential to prevent further complications and improve […]

Abstract Constrictive Pericarditis (CP) is an uncommon but potentially curable condition, typically presenting with right-sided heart failure and impaired ventricular filling. Diagnosis can be challenging and requires a structured approach that integrates various cardiovascular imaging modalities. This article offers a practical guide, based on evidence and clinical experience, for the step-by-step recognition of Constrictive Pericarditis, highlighting echocardiographic findings.

Abstract Fundamento: Cardiac amyloidosis is a rare form of infiltrative cardiomyopathy characterized by the deposition of proteins in the myocardium, resulting in increased wall thickness, impaired ventricular function, and possible progression to heart failure. Diagnosis is challenging due to the low prevalence of the disease and the nonspecific nature of its clinical manifestations. The application of artificial intelligence (AI) to the analysis of medical tests emerges as a promising strategy for early detection, more accurate diagnosis, and timely initiation of […]

ABSTRACT Cardiac sarcoidosis (CS) is a potentially severe manifestation of systemic sarcoidosis, associated with advanced atrioventricular block, ventricular arrhythmias, heart failure, and sudden death. Diagnosis remains challenging due to phenotypic variability and the limitations of conventional diagnostic methods. Advances in imaging techniques, especially the combination of positron emission tomography/computed tomography (PET/CT) using 18F-FDG and cardiac magnetic resonance imaging (CMR), have revolutionized the diagnostic approach and therapeutic monitoring of CS. This article reviews current concepts of CS and its diagnosis, with […]

ABSTRACT Monitoring systemic venous congestion has become essential in the management of critically ill patients, enabling accurate diagnosis, severity grading, and prognostic stratification. Literature shows that congestion is strongly associated with the development of acute kidney injury and increased mortality when compared with optimized volume states. In this setting, intraoperative Transesophageal Echocardiography (TEE) has emerged as an advanced and versatile tool. In addition to allowing detailed assessment of cardiac function, TEE is effective in assessing intravascular volume status and predicting […]

Abstract The assessment of coronary flow reserve is an extremely important step in stress echocardiography, both within and outside the context of coronary artery disease. For some, it is seen as an impossible parameter; for others, it is essential. In any case, everything begins with the proper visualization of the coronary arteries at rest. In this article, we will address theoretical and practical concepts for incorporating coronary flow study into the routine of the echocardiographer.

Abstract Right ventricular (RV) assessment using two-dimensional (2D) echocardiography has historically faced significant challenges due to the chamber’s complex and unique geometry and its thoracic orientation. In this context, three-dimensional (3D) echocardiography has emerged as a promising tool to overcome and illuminate these limitations, enabling accurate quantification of volumes and ejection fraction without relying on geometric assumptions. As a result, the routine incorporation of 3D echocardiography into RV evaluation may redefine diagnostic and prognostic paradigms, fostering a more precise and […]

Abstract Pericardial effusion is a common finding in cardiology practice. It is frequently identified in outpatient and inpatient follow-up examinations, especially during the postoperative period of heart surgery. In clinically stable patients, proper assessment can allow for early detection of signs of clinical deterioration. In patients in shock, careful analysis of pericardial effusion can confirm or rule out this condition as the main cause of hemodynamic instability. Precise identification of the location, anatomical characterization of severity, and analysis of hemodynamic […]