Right ventricular outflow tract obstruction in hypertrophic cardiomyopathy.

Recently, new cardiac imaging techniques as cardiac magnetic resonance have shown to play a primary role for a recognition of unusual mechanisms of right and left ventricular obstruction. However, echocardiography remains the most widely used technique and the first step to recognize myocardial hypertrophy, blood flow velocity, and pressure gradients in real time (2). We describe a rare case of hypertrophic cardiomyopathy with isolated obstruction of right ventricular out flow where transthoracic echocardiography was able to detect right ventricular hypertrophy and obstruction.

Double superior and inferior vena cava: unusual venous anomaly.

We report the case of a 56-year-old woman affected by recurrent paroxysmal atrial fibrillation and sick sinus syndrome. Before pacemaker implantation, a diagnosis of left superior vena cava persistency was made. After some years, at pacemaker replacement, an inferior vena cava anomaly was suspected because of the difficult progression of the lead for temporary pacing from the right femoral vein.