Echocardiography is the choice investigation. Classically,

tricuspid valve leaflets and its subvalvular apparatus is thickened; excursion of the leaflets become retracted, fixed, and noncoapting, leading to the valve remaining in a semiopen position. A “dagger-shaped” continuous wave-doppler profile resulting from severe tricuspid regurgitation with elevated right atrial pressure (that causes early peak pressure and its rapid decline) is seen at continuous wave-doppler record.7) Because the blood cannot be adequately ejected through the pulmonary valve, the right ventricle work increases. The right Inhibitors,research,lifescience,medical atrium and ventricle are enlarged becomes volume overloaded. But, RV function seemingly remains intact until quite Inhibitors,research,lifescience,medical late in the disease course. The heart’s lesions may cause right-sided heart failure. Three-DE provided more detailed anatomic informations about the tricuspid valve. In addition, it seems to be more useful for the assessment of RV size and function in comparison to two-dimensional echocardiography because it is not based on geometrical assumptions. The systo-diastolic RV shape highlights the unhomogeneous RV contractility related to the degree of its dysfunction. RV volumes and RVEF% evaluated with 3-DE were significantly increased (volumes) and decreased (ejection fraction) respectively, in comparison to the normals,8) Inhibitors,research,lifescience,medical and are well correlated

with MRI estimated as reference method.9) 3DE slightly overestimated RV end diastolic and end systolic volumes, although

the degree of overestimation was not significant. On the contrary, Inhibitors,research,lifescience,medical RVEF was underestimated in respect to MRI. Possibile reasons for these differences between 3-DE and MRI include difficulties in defining the endocardial borders, artifacts induced by the respiration movements and some BMS-754807 purchase uncertainties in to precisely identify valvular planes. Conclusively, while 2-D echocardiography is the choice method for define the valvular involvements in carcinoid heart disease, the 3-D echocardiography seems able Inhibitors,research,lifescience,medical to provide more detailed and precise anatomic and hemodynamic informations about RV size and function and valvular anatomic and functional changes.10),11)
Cardiac calcified amorphous tumors (CATs) are extremely Parvulin rare cardiac masses which can arise in all four cardiac chambers.1),2) While several causes of cardiac CATs have been suggested, the true etiology is not still clear. Cardiac CATs are usually benign, but sometimes cause diverse symptoms due to obstruction or embolization.1),3) We recently encountered a patient with a cardiac CAT causing multiple, calcific, pulmonary emboli and right-sided heart failure. A cardiac CAT has not been reported previously in Korea. Case A 33-year-old man sought evaluation in our outpatient clinic for progressive pretibial pitting edema and shortness of breath on exertion.