Dynamic assessment of 'valvular reserve capacity' in patients with rheumatic mitral stenosis.

Aims: Mitral stenosis (MS) may exhibit a dynamic valvular reserve. When resting gradients and systolic pulmonary pressure (sPAP) do not reflect the real severity of the disease, a dynamic evaluation becomes necessary. The aim of the study was to assess the clinical utility of exercise echocardiography in symptomatic patients with apparently subcritical MS.

Blood cyst of the mitral valve.

Blood cysts of the mitral valve are mostly benign diverticuli lined by endothelium and filled with blood and can be safely monitored with echocardiographic follow-up. We report a case of asymptomatic blood cyst of the mitral valve in a 63-year-old woman referred for a systolic murmur. At 3-year echo follow-up, the patient is free from notable clinical events.

Polypoid atrial myxoma.

Myxomas are by far the most common tumours of the heart. A 75-year-old man with no notable medical history presented with a 2-month progressive weight loss and dyspnoea on exertion. Physical examination revealed an opening snap and a diastolic decrescendo murmur at the apex.

Alcohol septal ablation versus surgical myectomy: a patient with obstructive HCM.

Background: A 42-year-old woman with a 20-year history of obstructive hypertrophic cardiomyopathy was referred for alcohol septal ablation following a worsening of symptoms, which had persisted despite medical treatment.

Investigations: Physical examination, electrocardiography, rest-exercise Doppler and two-dimensional echocardiography, coronary angiography, intracoronary myocardial contrast echocardiography, and intraoperative transesophageal and epicardial echocardiography.

Diagnosis: Symptomatic obstructive hypertrophic cardiomyopathy.

[Non-pharmacological treatment of hypertrophic obstructive cardiomyopathy guided by echocardiography].

As a relevant cause of symptoms and adverse clinical prognosis, left ventricular obstruction should be regarded as an important therapeutic target in patients with hypertrophic obstructive cardiomyopathy. The surgical approach (including septal myectomy or mitral valve surgery) and percutaneous transluminal septal myocardial ablation offer a non-pharmacological option for the treatment of symptomatic left ventricular obstruction and symptoms unresponsive to medical treatment. The surgical approach is established as an effective strategy for relieving symptoms from dynamic obstruction.