Image in Cardiology
Right ventricular hematoma
Hematoma do ventrículo direito
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(B) computed tomography (CT) image revealing a patent ductus arteriosus (PDA) in the frontal plane (blue arrow); (C) CT image showing a giant left pulmonary artery (8.32 cm); (D) coronary angiography showing a single coronary artery originating from the right coronary artery; (E) sizing balloon measuring the diameter of the PDA; (F) the duct is occluded by an Amplatzer muscular ventricular septal defect occluder.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Bekir Serhat Yildiz, Yusuf Izzettin Alihanoglu, Ismail Dogu Kilic, Harun Evrengul" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Bekir Serhat" "apellidos" => "Yildiz" ] 1 => array:2 [ "nombre" => "Yusuf Izzettin" "apellidos" => "Alihanoglu" ] 2 => array:2 [ "nombre" => "Ismail Dogu" "apellidos" => "Kilic" ] 3 => array:2 [ "nombre" => "Harun" "apellidos" => "Evrengul" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S217420491630109X?idApp=UINPBA00004E" "url" => "/21742049/0000003500000078/v2_201704060238/S217420491630109X/v2_201704060238/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S2174204916301076" "issn" => "21742049" "doi" => "10.1016/j.repce.2015.11.032" "estado" => "S300" "fechaPublicacion" => "2016-07-01" "aid" => "840" "copyright" => "Sociedade Portuguesa de Cardiologia" "documento" => "simple-article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "crp" "cita" => "Rev Port Cardiol. 2016;35:447.e1-3" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 2606 "formatos" => array:3 [ "EPUB" => 190 "HTML" => 2018 "PDF" => 398 ] ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case report</span>" "titulo" => "Rivaroxaban for the treatment of saphenous vein graft thrombosis" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "pt" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "447.e1" "paginaFinal" => "447.e3" ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "O rivaroxabano no tratamento da trombose do enxerto de veia safena" ] ] "contieneResumen" => array:2 [ "en" => true "pt" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 1584 "Ancho" => 1585 "Tamanyo" => 163035 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Saphenous vein graft to second obtuse marginal four weeks after rivaroxaban, in left anterior oblique view.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Konstantinos Marmagkiolis, Mehmet Cilingiroglu" "autores" => array:2 [ 0 => array:2 [ "nombre" => "Konstantinos" "apellidos" => "Marmagkiolis" ] 1 => array:2 [ "nombre" => "Mehmet" "apellidos" => "Cilingiroglu" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204916301076?idApp=UINPBA00004E" "url" => "/21742049/0000003500000078/v2_201704060238/S2174204916301076/v2_201704060238/en/main.assets" ] "en" => array:16 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Image in Cardiology</span>" "titulo" => "Right ventricular hematoma" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "449" "paginaFinal" => "450" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Rui Plácido, João Abecasis, Susana Gonçalves, Fausto J. Pinto, Ana G. Almeida" "autores" => array:5 [ 0 => array:4 [ "nombre" => "Rui" "apellidos" => "Plácido" "email" => array:1 [ 0 => "placidorui@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "João" "apellidos" => "Abecasis" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "Susana" "apellidos" => "Gonçalves" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 3 => array:3 [ "nombre" => "Fausto J." "apellidos" => "Pinto" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 4 => array:3 [ "nombre" => "Ana" "apellidos" => "G. Almeida" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Hospital Santa Maria, Serviço Cardiologia I, Lisbon Academic Medical Centre, CCUL, Lisbon, Portugal" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Unidade Cardiovascular, HPP Hospital dos Lusíadas, Lisbon, Portugal" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Hematoma do ventrículo direito" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1776 "Ancho" => 2918 "Tamanyo" => 479355 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">(A) Two-dimensional transthoracic echocardiography, modified short-axis view at the sub-tricuspid level, depicting a well-defined right ventricular mass (*) and part of the right coronary artery course along the atrioventricular groove (arrow); (B) three-dimensional (3D) transthoracic echocardiography, live 3D bird's eye view, modified 4-chamber view, showing a homogeneous and delimited ovoid mass (*) on a sub-tricuspid position; (C and D) mid-ventricular short-axis T1 and fat sat T2-weighted turbo spin-echo sequences, respectively, showing a hypointense homogeneous right ventricular mass (*) with no fat tissue; (E and F) mid-ventricular short-axis T1 post-contrast and phase-sensitive inversion recovery sequences, respectively, illustrating a small hyperintense core (arrowhead) inside the mass (*).</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We present the case of a 65-year-old male referred by an oncologist for transthoracic echocardiography because of effort dyspnea. His past medical history was remarkable for chronic obstructive pulmonary disease (COPD) and a gastric adenocarcinoma (pT2N1M0), resected three years previously and treated by adjuvant chemotherapy. Echocardiography revealed preserved biventricular ejection fraction, normal left ventricular diastolic indices, non-significant valvular dysfunction and no signs of pulmonary hypertension. However, a well-delimited 30 mm×23 mm×24 mm right ventricular (RV) ovoid, isoechogenic and homogeneous mass (<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>, asterisk) was observed along the basal free wall, in a sub-tricuspid position, well detached from the right coronary artery course (<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>, yellow arrow, and Videos 1 and 2).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">Cardiac magnetic resonance (CMR) allowed detailed tissue characterization. The mass was homogeneous and hypointense in both T1- (<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>C) and T2-weighted (<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>D) sequences, without fat tissue (Video 3). There was no detectable perfusion (Video 4) but a small core sign (<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>, arrowhead) was present on both T1 post-contrast (<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>E) and delayed enhancement (<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>F) acquisitions. No other abnormalities were noted, including pericardial or pleural effusions. In view of these findings, a benign cardiac mass was assumed. Repeated cardiac CMR at six and 12 months revealed similar findings.</p><p id="par0015" class="elsevierStylePara elsevierViewall">Notwithstanding the previous clinical history, the CMR study excluded malignant primary or secondary etiologies for this mass, even suggesting an alternative process. During investigation, the patient confirmed the occurrence of a severe blunt chest trauma in a traffic accident 20 years before. Indeed, the non-specific tissue data were in accordance with an organized hematoma of the RV free wall. In this specific case, symptoms were attributed to COPD progression, as assessed by pulmonary function tests.</p><p id="par0020" class="elsevierStylePara elsevierViewall">We found this case notable for the importance of CMR in the cardio-oncology setting. This tool provided biventricular functional assessment and excluded cardiac tumoral involvement, allowing confident risk stratification and conservative management. Furthermore, it led additional clinical investigation towards a definitive diagnosis of a very rarely reported cardiac condition.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Ethical disclosures</span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Protection of human and animal subjects</span><p id="par0025" class="elsevierStylePara elsevierViewall">The authors declare that no experiments were performed on humans or animals for this study.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Confidentiality of data</span><p id="par0030" class="elsevierStylePara elsevierViewall">The authors declare that they have followed the protocols of their work center on the publication of patient data.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Right to privacy and informed consent</span><p id="par0035" class="elsevierStylePara elsevierViewall">The authors declare that no patient data appear in this article.</p></span></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conflicts of interest</span><p id="par0070" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:3 [ "identificador" => "sec0005" "titulo" => "Ethical disclosures" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0010" "titulo" => "Protection of human and animal subjects" ] 1 => array:2 [ "identificador" => "sec0015" "titulo" => "Confidentiality of data" ] 2 => array:2 [ "identificador" => "sec0020" "titulo" => "Right to privacy and informed consent" ] ] ] 1 => array:2 [ "identificador" => "sec0035" "titulo" => "Conflicts of interest" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2015-08-18" "fechaAceptado" => "2015-08-24" "apendice" => array:1 [ 0 => array:1 [ "seccion" => array:1 [ 0 => array:4 [ "apendice" => "<p id="par0065" class="elsevierStylePara elsevierViewall"><elsevierMultimedia ident="upi0005"></elsevierMultimedia><elsevierMultimedia ident="upi0010"></elsevierMultimedia><elsevierMultimedia ident="upi0015"></elsevierMultimedia><elsevierMultimedia ident="upi0020"></elsevierMultimedia></p>" "etiqueta" => "Appendix A" "titulo" => "Supplementary material" "identificador" => "sec0030" ] ] ] ] "multimedia" => array:5 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1776 "Ancho" => 2918 "Tamanyo" => 479355 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">(A) Two-dimensional transthoracic echocardiography, modified short-axis view at the sub-tricuspid level, depicting a well-defined right ventricular mass (*) and part of the right coronary artery course along the atrioventricular groove (arrow); (B) three-dimensional (3D) transthoracic echocardiography, live 3D bird's eye view, modified 4-chamber view, showing a homogeneous and delimited ovoid mass (*) on a sub-tricuspid position; (C and D) mid-ventricular short-axis T1 and fat sat T2-weighted turbo spin-echo sequences, respectively, showing a hypointense homogeneous right ventricular mass (*) with no fat tissue; (E and F) mid-ventricular short-axis T1 post-contrast and phase-sensitive inversion recovery sequences, respectively, illustrating a small hyperintense core (arrowhead) inside the mass (*).</p>" ] ] 1 => array:7 [ "identificador" => "upi0005" "etiqueta" => "Movie 1" "tipo" => "MULTIMEDIAECOMPONENTE" "mostrarFloat" => false "mostrarDisplay" => true "Ecomponente" => array:3 [ "fichero" => "mmc1.mp4" "ficheroTamanyo" => 1451531 "Video" => array:2 [ "mp4" => array:2 [ "fichero" => "mmc1.m4v" "poster" => "mmc1.jpg" ] "flv" => array:5 [ "fichero" => "mmc1.flv" "poster" => "mmc1.jpg" "tiempo" => 0 "alto" => 0 "ancho" => 0 ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Two-dimensional transthoracic echocardiography, modified short-axis view at the sub-tricuspid level, depicting a well defined right ventricular mass and part of the right coronary artery pathway along the atrioventricular groove.</p>" ] ] 2 => array:7 [ "identificador" => "upi0010" "etiqueta" => "Movie 2" "tipo" => "MULTIMEDIAECOMPONENTE" "mostrarFloat" => false "mostrarDisplay" => true "Ecomponente" => array:3 [ "fichero" => "mmc2.mp4" "ficheroTamanyo" => 1530762 "Video" => array:2 [ "mp4" => array:2 [ "fichero" => "mmc2.m4v" "poster" => "mmc2.jpg" ] "flv" => array:5 [ "fichero" => "mmc2.flv" "poster" => "mmc2.jpg" "tiempo" => 0 "alto" => 0 "ancho" => 0 ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Three-dimensional (3D) transthoracic echocardiography, live 3D bird's-eye view, modified 4-chamber view, showing a homogeneous and delimited ovoid mass in a sub-tricuspid position.</p>" ] ] 3 => array:7 [ "identificador" => "upi0015" "etiqueta" => "Movie 3" "tipo" => "MULTIMEDIAECOMPONENTE" "mostrarFloat" => false "mostrarDisplay" => true "Ecomponente" => array:3 [ "fichero" => "mmc3.mp4" "ficheroTamanyo" => 55722924 "Video" => array:2 [ "mp4" => array:2 [ "fichero" => "mmc3.m4v" "poster" => "mmc3.jpg" ] "flv" => array:5 [ "fichero" => "mmc3.flv" "poster" => "mmc3.jpg" "tiempo" => 0 "alto" => 0 "ancho" => 0 ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Steady-state free precession cine cardiac magnetic resonance sequences, modified long-axis 4-chamber and short-axis views, showing an apparently encapsulated mass along the right ventricular (RV) trabeculae. This mass is slightly hypointense compared with the ventricular cavity, and shows a synchronous movement with the RV free wall.</p>" ] ] 4 => array:7 [ "identificador" => "upi0020" "etiqueta" => "Movie 4" "tipo" => "MULTIMEDIAECOMPONENTE" "mostrarFloat" => false "mostrarDisplay" => true "Ecomponente" => array:3 [ "fichero" => "mmc4.mp4" "ficheroTamanyo" => 47341740 "Video" => array:2 [ "mp4" => array:2 [ "fichero" => "mmc4.m4v" "poster" => "mmc4.jpg" ] "flv" => array:5 [ "fichero" => "mmc4.flv" "poster" => "mmc4.jpg" "tiempo" => 0 "alto" => 0 "ancho" => 0 ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Magnetic resonance perfusion sequences, modified long-axis 4-chamber and short-axis views, with no signal gain along the mass.</p>" ] ] ] ] "idiomaDefecto" => "en" "url" => "/21742049/0000003500000078/v2_201704060238/S2174204916301088/v2_201704060238/en/main.assets" "Apartado" => array:4 [ "identificador" => "9915" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Images in cardiology" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21742049/0000003500000078/v2_201704060238/S2174204916301088/v2_201704060238/en/main.pdf?idApp=UINPBA00004E&text.app=https://revportcardiol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204916301088?idApp=UINPBA00004E" ]
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