We report a 50 year-old hypertensive and asymptomatic woman in whom a left ventricular tumor was found on a routine two-dimensional. La sintomatología depende de su localización, aunque ocasionalmente no producen síntomas y su pesquisa es posible por el uso cada vez más frecuente de la ecocardiografía 3,4 . Caso clínicoMujer de 50 años, hipertensa, asintomática. En control ambulatorio rutinario se solicitó un ecocardiograma bidimensional transtorácico (Eco2D), luego de la auscultación de un soplo sistólico III/VI en el foco aórtico. El Eco2D reveló la existencia de una masa móvil al interior del ventrículo izquierdo de 5,0 x 1,3 cm, adherida al septum interventricular, con zonas de intensidad aumentada, sugerentes de calcificación (Figura 1, panel A), que provocaba una obstrucción parcial del tracto de salida del ventrículo izquierdo (TSVI), con gradiente máxima de 26 mmHg (Figura 1, panel B). No se observaron tumores adicionales en ninguna otra cámara cardiaca y los exámenes de laboratorio, radiografía de tórax y electrocardiograma resultaron normales. Para una mejor evaluación de la masa intraventricular, se realizó ecocardiografía tridimensional (Eco 3D), que permitió identificar la morfología multilobular del tumor, objetivándose -además-que ocupaba 65% del TSVI (Figura 1, panel C y D). Para complementar la evaluación, se efectuó resonancia cardiaca (RC) que mostró un tumor con señal isointensa respecto del tejido miocárdico y un pedúnculo de anclaje de 2 cm adherido al tercio superior del septum interventricular superior, que no interfería con el normal funcionamiento del aparato subvalvular mitral (Figura 1, panel E). En la imagen de inversión/recuperación posterior

Cardiac myxomas. Analysis of 78 cases Background: The incidence rates of cardiac tumors are low. Aim: To report the clinical presentation of cardiac myxomas and long-term evolution after resection. Material and Methods: Review of a database of surgical patients undergoing surgical resection of a cardiac myxoma in a public hospital between 1990 and 2018. Results: Seventy-eight patients aged 53 ± 15 years (65% females) were included. The most frequent comorbidities were arterial hypertension (40.5%), hypothyroidism (15%) and diabetes mellitus (12%). The main presenting symptoms were dyspnea (33%), neurological deficit secondary to embolism (30%) and acute pulmonary edema (5%). The most common location was the left atrium, in 87%. During surgery, cardiopulmonary bypass and aortic crossclamp times were 50.2 ± 19.6 and 33.4 ± 15.2 min, respectively. One patient died due to severe neurological involvement. Follow-up was completed in seventy-seven patients, with a mean echocardiographic follow-up time of 10.4 ± 7.7 years. Thirty-four patients were followed for more than 10 years. Six patients (7.7%) died during the follow-up and in six patients (7%) a recurrence was identified. Conclusions: Cardiac myxoma usually has nonspecific symptoms. Surgical excision offers excellent short and long-term results. Complications and recurrence rates are low in non-hereditary myxomas but obligates to perform echocardiographic follow-up for early diagnosis of recurrence.

Endomyocardial fibrosis (EMF) is a rare progressive restrictive cardiomyopathy of unknown etiology that mainly presents with heart failure. The presence of a small ventricle with obliteration of the apex and a large atrium are two-dimensional echocardiographic findings that are highly suggestive of EMF. Cardiac magnetic resonance with delayed enhancement allows detection of subendocardial fibrosis with good histopathological correlation, providing a noninvasive modality for diagnosing EMF. We herein report a case of EMF in which the complementary role of two-dimensional color Doppler imaging and myocardial contrast echocardiography proved to be useful in the diagnosis of this clinical entity, which was later confirmed by cardiac magnetic resonance, surgery, and histopathology.

(Rev Méd Chile 2007; 135: 1182-85).