[Echo-Doppler evaluation of recent onset chronic venous insufficiency in elderly patients: does the heart have a role?].

The onset in elderly subjects of clinical signs of chronic venous insufficiency (CVI), without a previous history of venous disease of the lower limbs, raises questions about the etiology. In our study we evaluated the possible causes investigating the venous system of the lower limbs and right heart function in elderly subjects with signs of CVI. The alterations found were on the reduction of TAPSE, a significantly higher body mass index and a reduced ability to walk compared to the control group.

[Congenital valvular heart disease with high familial penetrance].

Bicuspid valve aortic (BVA) is one of the most common congenital malformations. Only 20% of patients preserves a normal valve function throughout life. There are sporadic and familial forms, the latter to autosomal dominant.

[Correlation between insulin resistance and endothelial dysfunction assessed by flow-mediated dilation].

Insulin resistance and endothelial dysfunction are major cardiovascular risk factors. The purpose of this study was to determine whether only patients with insulin resistance also have an alteration of endothelial function assessed by ultrasound flow-mediated (FMD). In a population of 165 patients, 30 subjects had only a family history of diabetes and/or sporadic findings of hypoglycemia, and they were assessed for FMD, the glucose and insulin curve.

Myocardial deformation in acute myocarditis with normal left ventricular wall motion--a cardiac magnetic resonance and 2-dimensional strain echocardiographic study.

Background: The aim of our study was to assess longitudinal (L), circumferential (C) and radial (R) strain (S) of the left ventricle (LV) in patients with acute myocarditis and preserved LV wall motion.

Methods And Results: Of the 26 male patients that were enrolled, 13 patients (26+/-8 years) suffered from acute myocarditis and 13 (25+/-2 years) were healthy participants (controls). Both patients and controls underwent cardiac magnetic resonance (CMR) and 2-dimensional S imaging (2D-S) echocardiography on the same day.

Supraventricular tachycardia associated with a clinically isolated demyelinating syndrome.

Ion channels are essential to a wide range of physiological functions including neuronal signaling, muscle contraction, cardiac pacemaking, hormone secretion and cell proliferation. Linking ion-channel gene mutations to inherited disorders has been described. Ankyrins are intracellular proteins required for the biogenesis and maintenance of membrane domains in both excitable and non-excitable cells.

Patent foramen ovale: comparison among diagnostic strategies in cryptogenic stroke and migraine.

Objective: The aim of this study was to compare transthoracic echocardiography (TTE) and transcranial Doppler ultrasonography (TCD) with transesophageal echocardiography (TEE) in order to define the best clinical approach to patent foramen ovale (PFO) detection.

Methods: In total, 72 consecutive patients (33 men) with a mean age of 49 +/- 13 years were prospectively enrolled. The TEE indication was cryptogenic stroke (36 patients) or migraine (36 patients, 22 with aura).

Interatrial defect and patent ductus arteriosus.

We greatly appreciated the letter to the Editor by Rana Olgunturk and Serdar Kula. We can say that his interpretation coincides with our interpretation and with the knowledge about patent ductus arteriosus (PDA) and secundum atrial septal defects. Although functional closure of PDA usually occurs in the first few hours of life in healthy infants born at term (about 15 h of life in healthy infants born at term), true anatomic closure, in which the ductus loses the ability to reopen, may take several weeks.

Hashitoxicosis with pericardial effusion.

Previous studies have suggested that subclinical thyroid dysfunction is associated with detrimental effects on the cardiovascular system. Subclinical hyperthyroidism is an increasingly recognized entity that is defined as a normal serum free thyroxine and free triiodothyronine levels with a TSH level suppressed below the normal range and usually undetectable. It has been reported that subclinical hyperthyroidism is not associated with coronary heart disease or mortality from cardiovascular causes but it is sufficient to induce arrhythmias including atrial fibrillation and atrial flutter.

The chance finding at multislice computed tomography coronary angiography of myocardial bridging.

Myocardial bridging is present when a segment of a major epicardial coronary artery, the 'tunnelled artery', runs intramurally through the myocardium. With each systole, the coronary artery is compressed. The pathophysiology of myocardial bridging is incompletely understood.

The chance finding at multislice computed tomography coronary angiography of an ectopic origin of the left circumflex coronary artery from the right sinus of Valsalva.

Anomalous coronary arteries occur in less than 2% of the general population. Most coronary anomalies are clinically asymptomatic. However some of them may present with chest pain, syncope, heart failure and sudden death.

A rare case of lack of correlation of carotid atherosclerosis and coronary atherosclerosis.

Signs of plaque inflammation in carotid arteries may serve as a window to the entire cardiovascular system, to identify "vulnerable" patients. Moreover, flow-mediated vasodilation in the brachial artery and intima media thickness (IMT) in the carotid artery could represent a surrogate diagnostic method for assessment of coronary artery disease (CAD) severity. Renal function is an important predictor of the presence and severity of angiographic CAD in patients without severe renal impairment with incremental value over traditional risk factors for CAD and IMT.

The chance finding of an aneurysm of the right sinus of Valsalva in an 11-year-old child with a ventricular septal defect and a pericardial effusion.

Ventricular septal defects can occur as part of other congenital cardiac malformations or as an isolated finding. Aneurysms of the sinus of Valsalva are rare, most commonly involving the right or noncoronary sinuses. They can be congenital or acquired through infection, trauma, or degenerative diseases.

Handgrip exercise associated with dobutamine stress echocardiography.

Background: Stress echocardiography is today the best possible imaging choice in the field of noninvasive diagnosis of coronary artery disease. Dobutamine stress echocardiography (DSE) and Dobutamine-atropine stress echocardiography (DASE) have been studied. Handgrip (HG) exercise has been rarely studied in stress echocardiography.

A case of spontaneous closure of a muscular ventricular septal defect.

Ventricular septal defects can occur as part of more congenital cardiac malformations or as an isolate finding. Surgical closure, transcatheter occlusion and spontaneous closure have been reported. We present a case of spontaneous closure of a muscular ventricular septal defect.

A dilated alcoholic cardiomyopathy.

Dilated forms of cardiomyopathy are characterized by ventricular chamber enlargement and systolic dysfunction with normal LV wall thickness. Among other causes, chronic excessive consumption of alcohol has a very important presence. We present a case of a dilated alcoholic cardiomyopathy in a 65-year-old man.

Interatrial defect, ventricular septal defect and patent ductus arteriosus in a 2-day-old newborn infant.

Interatrial defects, ventricular septal defects, and patent ductus arteriosus can occur as part of more congenital cardiac malformations or as an isolate finding. We present a case of interatrial defect associated with ventricular septal defect and patent ductus arteriosus in a 2-day-old newborn infant.

Perinatal asphyxia and cardiac abnormalities.

The most common etiologies of myocardial infarction in the perinatal period are congenital heart disease, coronary artery lesions, thromboembolism and perinatal asphyxia. Cardiac abnormalities in perinatal asphyxia include tricuspid regurgitation and mitral regurgitation associated with transient myocardial ischemia of the newborn. Patent foramen ovale is a frequent remnant of the fetal circulation.

2-Dimensional strain echocardiography and early detection of myocardial ischemia.

Echocardiographic strain with strain rate imaging is a new technology enabling more reliable and comprehensive assessment of myocardial function. The spectrum of potential clinical applications is very wide due to its ability to differentiate between active and passive movement of myocardial segments, to quantify intraventricular dyssynchrony and to evaluate components of myocardial function, such as longitudinal myocardial shortening, that are not visually assessable. In-vivo and in-vitro validation of 2D-strain imaging technique have been undertaken and reached a point where it is considered ready for more widespread investigations into clinical utility, e.

Treatment failure of low molecular weight heparin in a patient with an aortic mechanical prosthesis.

After mechanical heart valve replacement use of unfractionated heparin is sometimes required because vitamin K antagonists are temporarily contraindicated or to prevent valve-associated thromboembolism until oral vitamin K antagonists take effect. Bridging therapy with a standardized low molecular weight heparin-based regimen has been reported effective and relatively safe in a large cohort of patients with mechanical heart valves. Many cases with mitral mechanical valve prostheses and treatment failure of low molecular weight heparin have also been reported as well as prosthetic valve thrombosis has been reported with adequate anticoagulation.