[Stress dobutamine echocardiography or resting strain rate imaging to unveil an early symptomatic diabetic cardiomyopathy?].

Diabetes mellitus has been associated with changes in the structure and function of the myocardium manifesting in the early stages of the disease as subtle systolic and diastolic dysfunction; myocardial strain imaging has recently been favored over dobutamine stress echocardiography for early detection of diabetic cardiomyopathy. We report a case of an elderly diabetic patient presenting with pulmonary edema in whom at rest echocardiographic parameters including strain rate were all within normal range, while dobutamine stress echocardiography induced a deep systolic deterioration unmasking an early-stage diabetic cardiomyopathy.

[Massive intraatrial mass?].

Posterior mediastinal hematoma in a rare and potentially lethal disease and is frequently consecutive to a traumatism. We report the original case of a 88-year-old male admitted to our department for lipothymia and syncope related to a severe compression of the left atrium by an important mediastinal hematoma mimicking in transthoracic echocardiography an obstructive intraatrial mass.

[Prethrombus acute constitution during dobutamine stress echocardiography].

Although generally regarded as a safe stress modality, dobutamine stress echocardiography (DSE) has been associated with several well described complications. However, to our knowledge, acute constitution of thrombi during the stress test has never been described. In this report, we present the case of a 64 year-old man with a history of ischemic heart disease who underwent a preoperative DSE; during the test, we witnessed a striking acute constitution of an intense prethrombotic state with almost a formation of a highly mobile massive thrombus adjacent to the infero-apical segment spontaneously resolving few minutes after the end of the test.

[Atypical form of cor triatrium in a 59-year-old man].

Cor triatrium is a rare congenital heart disease typically diagnosed amongst very young patients. Delayed diagnosis in the elderly is much more unusual. We report the case of a 59-year-old male with unremarkable medical history in whom we have discovered, on an echocardiography performed for an exploration of transient ischemic accident with atrial fibrillation, a particular form of an isolated cor triatrium dextrum investigated with multimodality imaging.

[Biphasic reaction to dobutamine stress echocardiography as a predictor of coronary artery spasm: Apropos of 3 cases].

Dobutamine-related coronary spasm is a possible complication of dobutamine stress echocardiography potentially explaining a part of some erroneously labeled "false positive tests". Presently, there are no established echographic predictors of coronary spasm. We report 3 clinical cases in which dobutamine-induced spasm was strongly suspected on the basis of a biphasic reaction including an initial deterioration rapidly followed by a spontaneous recovery in well-defined echocardiographic territory.