Abstract Mitral stenosis (MS) is the main clinical expression of chronic rheumatic heart disease. In symptomatic patients with severe MS and favorable anatomy, percutaneous mitral balloon valvuloplasty (PMBV) is the first-line therapeutic strategy. For the proper selection of candidates, the Wilkins-Block echocardiographic score was developed to characterize mitral valve morphology and predict eligibility for the procedure. This score includes four structural domains: leaflet mobility, valve thickening, degree of calcification, and subvalvular apparatus involvement, grading each parameter from 1 to 4 […]

Abstract Infective endocarditis remains a serious condition with high morbidity and mortality rates despite advances in diagnostic and therapy. While the Global North has seen a shift toward older patients with prosthetic valve infections, Brazil’s understanding of the disease is hindered by reliance on fragmented, hospital-based data, primarily from the Southeast region. This narrative review synthesizes recent evidence to outline the national panorama. Population studies indicate an increase in incidence and mortality, primarily affecting men and the elderly, but with […]

Introduction Primary cardiac tumors are rare entities, approximately 75% of which are benign, with myxoma as the most common type., Only about 15% of primary cardiac tumors are malignant, predominantly sarcomas. In contrast, metastatic cardiac involvement is relatively frequent and has been identified in up to 9% of patients who died from cancer. Clinical manifestations are more closely related to tumor location than to histopathological classification. They may result from embolic phenomena, intracardiac obstruction with signs of heart failure (HF), […]

Introduction Tricuspid atresia with pulmonary atresia is a rare congenital heart defect, representing about 1% to 3% of all congenital heart diseases. Tricuspid atresia is subdivided into type I (normal position of the great arteries) and type II (transposition of the great arteries), with type 1A characterized by the presence of associated pulmonary atresia or stenosis. Pulmonary blood flow in these patients is dependent on the patency of the ductus arteriosus, making its maintenance essential in the neonatal period. The […]

Introduction In contemporary cardiovascular imaging, one of the methods that has gained significant relevance by adding diagnostic and prognostic information is speckle-tracking–derived Longitudinal Strain, particularly the assessment of left ventricular Global Longitudinal Strain (GLS). However, although GLS evaluates global myocardial deformation of the left ventricle, it is highly dependent on loading conditions, which may interfere with the accurate interpretation of its results. In this context, an emerging technique has been introduced, also derived from speckle tracking: Myocardial Work (MW). Compared […]

A 59-year-old male patient with a history of systemic arterial hypertension was admitted to the emergency department with a seven-day history of chest pain and palpitations. On examination, he was hypotensive (93/70 mmHg) and tachycardic (150 bpm). A prominent systolic–diastolic murmur was heard along the right upper sternal border. The initial investigation included electrocardiography (ECG) and Transthoracic Echocardiography (TTE). The ECG revealed atrial flutter, and the TTE showed biventricular dilation [Left Ventricular (LV) end-diastolic/end-systolic diameters: 60/51 mm; right ventricular (RV) […]

Abstract Assessment of left ventricular systolic function is central to transthoracic echocardiography and remains essential in clinical practice and research. Although left ventricular ejection fraction is still the most widely used parameter, advances in echocardiographic techniques have broadened diagnostic assessment. This review summarizes key methods for evaluating systolic function, from traditional linear measurements to modern two- and three-dimensional volumetric approaches. The roles and limitations of the Simpson method, contrast echocardiography, three-dimensional imaging, myocardial deformation analysis, and artificial intelligence are discussed, […]

Ventricular septal morphology and cardiac development Anderson et al. convened international experts to propose a unified morphofunctional classification of ventricular septal defects, with emphasis on embryological features and ventriculoarterial connections. The authors critically examine the nomenclature currently in use and suggest that defect descriptions should encompass both their anatomical location and the borders involved. This approach integrates principles of cardiac development and allows, for example, differentiation between perimembranous defects in hearts with double outlet right ventricle and those with concordant […]

Introduction Calcium is a fundamental component of biological systems and plays a key role in excitation-contraction coupling in cardiac myocytes. Calcium entry triggers a mechanism known as calcium-induced calcium release, in which calcium released from the sarcoplasmic reticulum is modulated by the influx of calcium from the extracellular space. Muscle contraction subsequently occurs through the interaction between calcium and the troponin-tropomyosin complex. In the heart, intracellular calcium is the primary regulator of contractile force (inotropism). Hypocalcemia-induced cardiomyopathy is a rare […]

Discussion The DPAA (pedal artery) was first described in 1907. Since then, other authors have reported this rare type of aneurysm, but its clinical manifestations are still relatively unknown. With only 24 cases reported in the literature until 2017, according to Aragão et al., the DPAA aneurysm is more common among men (63%) with a mean age of 55.4%. In general, it appears as a pulsatile mass, which may lead to microembolization, hemorrhage, rupture, and nerve compression. Physical examination usually […]

Abstract Background: Cardiotoxicity is a serious adverse effect of chemotherapy, often identified only after irreversible myocardial damage has occurred. Positron emission tomography/computed tomography (PET/CT) using fluorine-18 fluorodeoxyglucose (18F-FDG) allows for the evaluation of myocardial glucose metabolism and may help detect early metabolic changes related to chemotherapy. Objective: To assess changes in 18F-FDG standardized uptake values (SUVs) across different cardiac regions before and after chemotherapy in patients with lymphoma, and to identify which region exhibits the greatest increase. Methods: This retrospective […]

Hypertrophic cardiomyopathy (HCM) is the most prevalent genetic heart disease, affecting approximately 1 in 500 individuals in the general population,– with asymmetric septal hypertrophy as the most common phenotype. In obstructive HCM (oHCM), clinical relevance is greater due to its association with atrial fibrillation, heart failure, thromboembolic events, arrhythmias, and sudden cardiac death., For patients who remain symptomatic despite optimized medical therapy, septal reduction has become an established strategy, with surgical septal myectomy as the gold standard. Alcohol septal ablation […]

Introduction Globally, strokes are the second leading cause of mortality,, and are broadly categorized into hemorrhagic and ischemic types., In 2019, ischemic stroke accounted for 62.4% of all cases, totaling 7.63 million episodes. Projections indicate a substantial increase in stroke prevalence, from 3.9% in 2020 to an estimated 6.4% by 2050. Despite comprehensive etiological investigations, the underlying cause of cerebrovascular ischemic events remains undefined in 10% to 40% of the cases, known as cryptogenic stroke. Stroke is often a disabling […]