Right ventricular wall motion was assessed in parasternal
long axis , parasternal
short axis, RV inflow and apical four chamber views.
For the LVGS imaging, the patients were positioned in the supine position and after the assessment of the patient's heart rhythm, 2Dimagery data (video clip) were recorded from the apical 2-, 3-, and 4-chamber and parasternal
short-axis images that included at least three cardiac cycles at a rate of 50-75 frames/sec, accompanied by regular ECG signals in the tissue velocity imaging mode and subsequently stored for an offline analysis.
Caption: FIGURE 1 Parasternal
long-axis view of the heart in early diastole
We performed all the echocardiographic studies at baseline and 8 weeks later as previously proposed.,, Interventricular septum thickness, LV end-diastolic dimension, LV end-systolic dimension (LVDs), and LV ejection fraction were measured from the M-mode of left parasternal
short-axis standard views at the level of papillary muscle.
long axis view was remarkable for massive dilatation and hypokinesia of the right ventricle (RV).
long axis view of transthoracic echocardiogram showing large circumferential pericardial effusion with evidence for tamponade physiology.
Image 3: ultrasound of parasternal
long axis (PLAX) view of heart: biventricular dilation.
short axis view (apex) showing a large pericardial effusion (>5cm) with a swinging heart.
B-mode images of the heart were acquired with the higher frequency probe in parasternal
long axis (PLAX) and short axis (SAX) views (Figures 1(a) and 1(b), resp.) and then analyzed offline to calculate left ventricular mass (LVmass), cardiac output (CO), fractional shortening (FS), stroke volume (SV), and ejection fraction (EF) from semiautomatic tracings of the ventricle borders in PLAX by means of the LV Trace software (FUJIFILM VisualSonics Inc., Toronto, Canada) .
Caption: Figure 2: Transthoracic echocardiogram showing moderate-size pericardial effusion in both parasternal
short axis view ((a) systole; (b) diastole) and parasternal
long axis view ((c) systole; (d) diastole).
Caption: Figure 2: Transesophageal echocardiogram, parasternal
long axis view.
Despite the clinical improvement and stability, on the 38[degrees] PO clinical staff noted the appearance of ulcerated nodule of around 1 cm of diameter in in the right parasternal
region, suggestive of local recurrence, which increased progressively, presenting a measure of around 3 cm at the moment of the patient discharge (Figure 5).