Two-dimensional transthoracic contrast echocardiographic assessment of metastatic left ventricular tumors.

To illustrate the usefulness of contrast echocardiography in the assessment of cardiac tumors, we present an 81-year-old female with pathological fracture of the right clavicle in whom biopsy showed poorly differentiated carcinoma. Two-dimensional transthoracic echocardiography found two masses in the left ventricle attached to mid-ventricular septum consistent with metastases. Echo contrast study with octafluoropropane (Optison) showed contrast enhancement of both the masses consistent with high vascularity seen in a malignant tumor.

The use of contrast echocardiography in the diagnosis of an unusual cause of congestive heart failure: achalasia.

Extrinsic compression of the left atrium is a potentially life-threatening but unusual cause of congestive heart failure. Achalasia is a motility disorder characterized by impaired relaxation of the lower esophageal sphincter and dilation of the distal two-thirds of the esophagus. We report only the third known case in the world literature of massive left atrial compression by a dilated esophagus in a patient with achalasia.