Rheumatic heart disease with a mitral blood cyst: three-dimensional echocardiographic imaging

Abstract

ReFeRenCeS

Blood cysts of the cardiac valves in adults: Review and analysis of published cases

“…Our literature search has documented a total of 50 articles considered eligible for analysis and reporting a total of 54 patients; 36 (72%) are reports of a single case, 3–38 12 (24%) images in cardiovascular disease, 39–50 1 case series reporting 5 patients (2%), 51 and 1 letter to the editor (2%), 52 all published from 1960 to 2021 (Tables 1 and 2).…”

“…1,2 They are considered benign tumors, nevertheless, while benign from the histologic point of view, they have been associated to relevant complications such as LVOT obstruction and coronary or systemic embolization with consequent severe sequelae such as stroke or myocardial infarction. 4,5,9,11,15,18,20,48 Transthoracic or transesophageal 2D echo are usually considered adequate to detect intracardiac masses even of small dimensions and the presence of an echo-free space within the mass may usually rise the suspicion of the presence of a BC; others have considered formation of microbubbles inside the cyst, when using contrast real-time echocardiography, as pathognomonic of the presence of a BC. 12,17 However, sometimes solid cardiac tumors, such as myxomas, may present with similar echocardiographic features, therefore, being difficult to be differentiated from a benign BC.…”

“…Intracardiac BCs are usually incidental necropsy findings or are diagnosed clinically predominantly in children, being extremely rare after the first year of life and particularly in adults 1,2 . They are considered benign tumors, nevertheless, while benign from the histologic point of view, they have been associated to relevant complications such as LVOT obstruction and coronary or systemic embolization with consequent severe sequelae such as stroke or myocardial infarction 4,5,9,11,15,18,20,48 . Transthoracic or transesophageal 2D echo are usually considered adequate to detect intracardiac masses even of small dimensions and the presence of an echo‐free space within the mass may usually rise the suspicion of the presence of a BC; others have considered formation of microbubbles inside the cyst, when using contrast real‐time echocardiography, as pathognomonic of the presence of a BC 12,17 .…”

BLOOD CYSTS OF THE CARDIAC VALVES IN ADULTS Review and analysis of published cases

“…Intracardiac BCs are usually incidental necropsy findings or are diagnosed clinically predominantly in children, being extremely rare after the first year of life and particularly in adults 1,2 . They are considered benign tumors, nevertheless, while benign from the histologic point of view, they have been associated to relevant complications such as LVOT obstruction and coronary or systemic embolization with consequent severe sequelae such as stroke or myocardial infarction 4,5,9,11,15,18,20,48 . Transthoracic or transesophageal 2D echo are usually considered adequate to detect intracardiac masses even of small dimensions and the presence of an echo-free space within the mass may usually rise the suspicion of the presence of a blood cyst; others have considered formation of microbubbles inside the cyst, when using contrast real-time echocardiography, as pathognomonic of the presence of a BC 12,17 .…”

“…Our Literature search has documented a total of 50 articles considered eligible for analysis and reporting a total of 54 patients; 36 (72%) are reports of a single case , 12 (24%) images in cardiovascular disease [39][40][41][42][43][44][45][46][47][48][49][50] , 1 a case series reporting 5 patients (2%) 51 and 1 a letter to the Editor (2%) 52 , all published from 1960 to 2021 (Table 1 and 2…”