Papillary fibroelastomas: innocent bystanders or ignored culprits?

Cardiac papillary fibroelastomas (PFEs) are the most common tumors of the cardiac valves and the third most common cardiac tumor. They are usually detected accidentally on echocardiography, but have the potential to manifest with catastrophic embolic phenomena, resulting in stroke and myocardial infarction. Echocardiography is currently the preferred diagnostic modality, while magnetic resonance imaging and computed tomography are helpful in the differential diagnosis of cardiac tumors.

Delineation of intracardiac shunts using contrast echocardiography.

Contrast echocardiography is useful to visualize the endocardial borders of the left ventricle and improve the signal intensity of spectral Doppler signals. It can also help to define intracardiac flow dynamics in complex situations. We report 2 cases where contrast echocardiography improved the delineation of complex shunts and also provided new information not available by conventional echocardiography.