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Abstract Background Adverse effects and inconclusive results may occur on dobutamine stress echocardiography. Objective To assess the safety and feasibility of dobutamine stress echocardiography in a large general population. Methods A total of 10,006 dobutamine stress echocardiographies were performed between July 1996 and September 2007. Dobutamine was administered in four stages (10, 20, 30, and 40 μcg·kg-1·min-1) to research myocardial ischemia starting with 5 μcg·kg-1·min-1 to analyze myocardial viability. Atropine was started according to the protocols used in the period. […]

Abstract Background The urbanization process impacts the burden of cardiovascular disease (CVD). Indigenous populations can undergo a devastating epidemiological transition. Objective The present study aimed to describe the Project of Atherosclerosis among Indigenous Populations (PAI) study protocol for assessing echocardiographic images and subclinical CVD in indigenous populations according to the degree of urbanization and report its preliminary results. Methods The PAI is a cross-sectional study that includes volunteers aged 30–70 years among Brazilian indigenous groups exposed to low and advanced […]

Abstract Background Myocardial infarction is one of the major causes of morbidity and mortality worldwide and 13.2% of patients with acute coronary syndrome have normal or unobstructed coronary arteries, called MINOCA (Myocardial Infarction with Non-Obstructive Coronary Artery). Cardiac magnetic resonance (CMR) is the gold standard for investigating the etiology of acute coronary syndrome. Although MINOCA has a more benign evolution than myocardial infarction due to coronary obstruction, its prognostic factors are not completely elucidated. Objective To evaluate prognosis, predictive factors […]

Abstract Background Left ventricular ejection fraction is one of the most used echocardiographic parameters in clinical practice. Its estimation by two-dimensional manual method (Simpson method) has limited reproducibility and accuracy, and semi-automatic methods have been proposed. It becomes necessary to compare the semi-automatic two-dimensional method with more accurate methods of assessing left ventricular ejection fraction, such as measurement by automatic three-dimensional echocardiography. Objective To compare the left ventricular ejection fraction, and left ventricular end-diastolic and end-systolic volumes estimates by the […]

Abstract Background Stroke is prevalent worldwide, and early recognition of subclinical cardiovascular (CV) disease could predict a first ischemic stroke (IS) episode. Speckle-tracking echocardiography (STE) allows the detection of early subclinical myocardial dysfunction. Aim To examine the association between myocardial deformation, evaluated by STE, and first episode of IS in a sample of otherwise healthy patients. Methods We included individuals between 40–80 years old, with a first incidence of IS, with no known CV disease, matched to healthy controls by […]

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Abstract Background Myocardial infarction with nonobstructive coronary arteries (MINOCA) is diagnostically and therapeutically challenging for clinicians, as a large spectrum of causes may result in this clinical condition, multiple entities can mimic it, and there are relatively few evidence-based recommendations for its assessment. Discussion Accurate diagnosis of the underlying etiology of MINOCA requires a systematic and dynamic evaluation of the clinical history and work-up of each patient, as well as the use of additional diagnostic tools that allow more in-depth […]

Abstract Atrial myxomas may progress asymptomatically or present systemic manifestations. Echocardiography is an effective complementary exam to diagnose such pathology. Cardiac surgery represents the definitive treatment; particularly when performed early, it can avoid tumor growth–related complications. This article reports the case of an elderly high-risk cardiovascular patient admitted with acute ST elevation myocardial infarction in a cardiac unit progressing with cardiogenic shock, which contributed to the low suspicion of cardiac tumor as the initial diagnosis.

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Abstract Myxomas are rare entities that represent the majority of benign cardiac tumors in adults. Their clinical presentation may vary by dimension and location, and they can occur in asymptomatic individuals as an incidental finding of cardiac mass from imaging exams. This article reports the case of a female patient with no known comorbidities who was admitted to the emergency department with acute heart failure. Transthoracic echocardiography revealed a mass in left atrium corresponding to a giant myxoma partially occluding […]

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