A 33-year-old Brazilian man was admitted to the emergency department with sudden onset of global aphasia and right hemiparesis. An urgent CT angiography of the cerebral arteries confirmed the stroke diagnosis, showing an occlusion of the left internal carotid artery. The patient underwent systemic thrombolysis and mechanical thrombectomy with subsequent neurological improvement. Considering the stroke diagnosis in a young adult most likely of cardioembolic origin, he undertook a thorough diagnostic workup. Of importance, he had a family history of cardiomyopathy, […]

Case We present the case of a 52-year-old man with hepatitis C and a history of intravenous drug abuse, admitted to the infectology department with spondylodiscitis and psoas muscle abscess. Staphylococcus aureus was isolated from blood, urine, and spinal fluid cultures, and the transthoracic echocardiogram was negative for vegetation, abscess, or fistula. The transesophageal echocardiogram (TEE) showed a filamentous and mobile structure attached to the atrial surface of the mitral valve (MV), and a diagnosis of infective endocarditis was presumed. […]

A 71-year-old woman was admitted to our center, complaining of fatigue, dyspnea, and anorexia. Physical examination revealed a grade III low-pitched diastolic murmur at the mitral focus. Transthoracic echocardiogram (TTE) showed an oval mass inside the left atrium (LA) extending from its roof to the mitral valve ( ), causing significant transmitral pressure gradient ( ). Transesophageal echocardiogram (TEE) ( ) raised the suspicion of left superior pulmonary vein involvement, which was confirmed by computed tomography (CT) angiography ( ). […]

Case Description A 40-year-old woman diagnosed with tuberous sclerosis (TS) at the age of one, with cognitive impairment, epilepsy and renal angiomyolipomas, was referred to Cardiology for complaints of fatigue. She had no known family history of TS. Although her mother could not confirm if a genetic test had been performed, the patient had a definite diagnosis of TS, according to International Tuberous Sclerosis Consensus Group revised criteria, due to the presence of several major criteria, as hypomelanotic macules, facial […]

Abstract Mitral annular calcification (MAC) is a commonly observed chronic and degenerative fibrotic process of the base of the mitral valve, usually deemed as an incidental finding. Although initially, MAC was thought to be a consequence of an age-related degenerative process, recent findings suggest other independent contributive mechanisms, such as atherosclerosis and abnormal calcium-phosphorus metabolism. Caseous calcification of the mitral annulus (cMAC) is a rarely described variant of MAC, characterized by an ovoid, focal mass with internal caseous fluid-like calcifications […]

A 49-year-old female was found to have an incidental right atrial mass on a routine transthoracic echocardiography (TTE) ( ). She reported no previous significant medical history, besides a mammoplasty in 2017 complicated with implant rupture in 2019. She did not take any medication, was fit and well, and showed full exercise tolerance. There were no risk factors for venous thromboembolism, and she had no significant family medical history. The patient is a former smoker of 12 pack-years. She had […]

A 41-year-old woman was admitted to the emergency room with an onset of acute dyspnea, jugular ingurgitation, and with the first heart sound diminished, followed by a grade III/IV holosystolic murmur that was better heard at the apex and edema of the lower limbs. The vital signs were heart rate 91 bpm, respiratory rate 21 rpm, blood pressure 110/60 mmHg, and oxygen saturation 91%. The chest x-ray showed cardiomegaly with a cardiothoracic index of 0.62 and pulmonary venocapillary hypertension. […]

Three-dimensional (3D) echocardiogram with transillumination (TI) is a novel 3D rendering tool that enhances specific image features not optimally displayed by conventional 3D imaging. Conventional 3D rendering lacks consistency regarding image details and depth perception, often presenting suboptimal images. Transillumination 3D imaging benefits from the integration of a movable virtual light source into the data set. The light source can be moved anteriorly or posteriorly and from side to side, being positioned at specific locations in order to highlight the […]

Introduction Primary cardiac tumors are extremely rare, with their incidence varying between 0.0017 and 0.28%, among which is the malignant germ cell yolk sac tumor (YST). Although transthoracic echocardiography (TTE) is often the first line in the evaluation of cardiac tumors, currently, due to its good spatial resolution and tissue characterization, cardiac magnetic resonance (CMR) imaging is the technique of choice for the evaluation of these tumors., The intracardiac YST is a rare neoplasm, with few reported cases.– […]

Systemic Lupus Erythematosus (SLE) is an autoimmune disease with a wide spectrum of clinical manifestations. The cardiovascular system has relevant clinical importance among the affected organs because it is associated with higher mortality in these patients. The heart can be affected in any structure, and lupus myocarditis is a major diagnostic challenge in clinical practice. Non-invasive tests such as electrocardiograms and echocardiograms are not sensitive or specific enough for this diagnosis. Cardiac magnetic resonance imaging (CMR) is the preferred imaging […]