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array:25 [ "pii" => "S2174204919301552" "issn" => "21742049" "doi" => "10.1016/j.repce.2019.06.005" "estado" => "S300" "fechaPublicacion" => "2019-05-01" "aid" => "1270" "copyright" => "Sociedade Portuguesa de Cardiologia" "copyrightAnyo" => "2018" "documento" => "article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "sco" "cita" => "Rev Port Cardiol. 2019;38:387-8" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 387 "formatos" => array:3 [ "EPUB" => 51 "HTML" => 233 "PDF" => 103 ] ] "Traduccion" => array:1 [ "en" => array:20 [ "pii" => "S0870255118302828" "issn" => "08702551" "doi" => "10.1016/j.repc.2018.05.012" "estado" => "S300" "fechaPublicacion" => "2019-05-01" "aid" => "1270" "copyright" => "Sociedade Portuguesa de Cardiologia" "documento" => "article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "sco" "cita" => "Rev Port Cardiol. 2019;38:387-8" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 1181 "formatos" => array:3 [ "EPUB" => 108 "HTML" => 716 "PDF" => 357 ] ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Image in Cardiology</span>" "titulo" => "Patent foramen ovale may not always be benign in the elderly" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "387" "paginaFinal" => "388" ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "<span class="elsevierStyleItalic">Foramen</span> oval patente pode não ser sempre benigno no idoso" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "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" => 1163 "Ancho" => 2083 "Tamanyo" => 211496 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A – Transesophageal echocardiography (TEE) reveals the passage of a large thrombus through the patent foramen ovale, which later led to stroke. B – TEE shows a smaller thrombus following the initiation of unfractionated heparin. C – Transthoracic echocardiography reveals no thrombus.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Ana Aires, Nuno Oliveira, Filipe Macedo, Elsa Azevedo" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Ana" "apellidos" => "Aires" ] 1 => array:2 [ "nombre" => "Nuno" "apellidos" => "Oliveira" ] 2 => array:2 [ "nombre" => "Filipe" "apellidos" => "Macedo" ] 3 => array:2 [ "nombre" => "Elsa" "apellidos" => "Azevedo" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2174204919301552" "doi" => "10.1016/j.repce.2019.06.005" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204919301552?idApp=UINPBA00004E" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255118302828?idApp=UINPBA00004E" "url" => "/08702551/0000003800000005/v3_201911281014/S0870255118302828/v3_201911281014/en/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S2174204919301485" "issn" => "21742049" "doi" => "10.1016/j.repce.2019.06.001" "estado" => "S300" "fechaPublicacion" => "2019-05-01" "aid" => "1385" "documento" => "simple-article" "crossmark" => 0 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "prv" "cita" => "Rev Port Cardiol. 2019;38:389" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 237 "formatos" => array:3 [ "EPUB" => 50 "HTML" => 110 "PDF" => 77 ] ] "en" => array:9 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">ARTIGO RECOMENDADO DO MÊS</span>" "titulo" => "Brief Comment Video to the Recommended Article of the Month" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "389" ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Breve Comentário Vídeo ao Artigo Recomendado do Mês" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S0870255119303051" "doi" => "10.1016/j.repc.2019.05.004" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255119303051?idApp=UINPBA00004E" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204919301485?idApp=UINPBA00004E" "url" => "/21742049/0000003800000005/v2_201911300820/S2174204919301485/v2_201911300820/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S2174204919301540" "issn" => "21742049" "doi" => "10.1016/j.repce.2019.06.004" "estado" => "S300" "fechaPublicacion" => "2019-05-01" "aid" => "1256" "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. 2019;38:385.e1-385.e4" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 357 "formatos" => array:3 [ "EPUB" => 48 "HTML" => 207 "PDF" => 102 ] ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case report</span>" "titulo" => "Identification of a critical isthmus in complex macroreentrant atrial tachycardia using Ripple mapping in a patient with surgically repaired Ebstein's anomaly" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "pt" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "385.e1" "paginaFinal" => "385.e4" ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Identificação do istmo crítico de uma taquicardia auricular complexa por macroreentrada utilizando o mapeamento Ripple num doente com anomalia de Ebstein corrigida cirurgicamente" ] ] "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" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1751 "Ancho" => 2333 "Tamanyo" => 234887 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Ripple map of the second flutter, displayed over a bipolar voltage map: the wavefront ascended between the crista terminalis and the intercaval line, went around the right atrial appendage and descended anteriorly to the crista terminalis (A to D) through the slow conducting isthmus. As the isthmus is a cicatricial zone, the Ripple bars are smaller in number and in amplitude. As such, six Ripple marks and corresponding electrograms are displayed and marked (D and E). The slow conduction through the critical isthmus began at mark 1 and spread to mark 6.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Gustavo Lima da Silva, Nuno Cortez-Dias, Luís Carpinteiro, João de Sousa" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Gustavo" "apellidos" => "Lima da Silva" ] 1 => array:2 [ "nombre" => "Nuno" "apellidos" => "Cortez-Dias" ] 2 => array:2 [ "nombre" => "Luís" "apellidos" => "Carpinteiro" ] 3 => array:2 [ "nombre" => "João" "apellidos" => "de Sousa" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204919301540?idApp=UINPBA00004E" "url" => "/21742049/0000003800000005/v2_201911300820/S2174204919301540/v2_201911300820/en/main.assets" ] "en" => array:15 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Image in Cardiology</span>" "titulo" => "Patent foramen ovale may not always be benign in the elderly" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "387" "paginaFinal" => "388" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Ana Aires, Nuno Oliveira, Filipe Macedo, Elsa Azevedo" "autores" => array:4 [ 0 => array:4 [ "nombre" => "Ana" "apellidos" => "Aires" "email" => array:1 [ 0 => "ana.aires.mail@gmail.com" ] "referencia" => array:3 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 2 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Nuno" "apellidos" => "Oliveira" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] 2 => array:3 [ "nombre" => "Filipe" "apellidos" => "Macedo" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] 3 => array:3 [ "nombre" => "Elsa" "apellidos" => "Azevedo" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Department of Neurology, São João Hospital Center, Porto, Portugal" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Faculty of Medicine, University of Porto, Porto, Portugal" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Department of Cardiology, São João Hospital Center, Porto, Portugal" "etiqueta" => "c" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "<span class="elsevierStyleItalic">Foramen</span> oval patente pode não ser sempre benigno no idoso" ] ] "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" => 1163 "Ancho" => 2083 "Tamanyo" => 211496 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A – Transesophageal echocardiography (TEE) reveals the passage of a large thrombus through the patent foramen ovale, which later led to stroke. B – TEE shows a smaller thrombus following the initiation of unfractionated heparin. C – Transthoracic echocardiography reveals no thrombus.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 65-year-old woman was admitted to the hospital with fever and decompensated heart failure. She had long-lasting peripheral venous insufficiency and had been experiencing heart failure symptoms for six months. She had no history of hypertension, diabetes mellitus, coronary heart disease, atrial fibrillation, stroke or transient ischemic attack. Six days after admission, she developed acute pulmonary edema. A transesophageal echocardiography (TEE) revealed severe left ventricular dysfunction and an intracardiac thrombus measuring 5-6 cm, traversing a small patent foramen ovale (PFO) (<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>A). Unfractionated heparin was promptly initiated. Nevertheless, one week later, she woke up aphasic with right-sided hemiparesis. A brain computed tomography scan showed a left hemispheric stroke, while the patient's blood work, a cervical duplex scan and cardiac catheterization revealed no significant findings. The TEE was repeated and a smaller thrombus found (<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>B). Two months after discharge, the thrombus was undetectable (<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>C).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">PFO is not considered to be a major cause of cardioembolic stroke, especially in the elderly, since other potential causes exist. Our case, however, shows that a causative thrombus resulting from a paradoxical PFO embolism could be detected before giving rise to a stroke. This case is important as it allowed direct thrombus imaging within the PFO before it led to a stroke, which is not always possible, as well as revealing a smaller thrombus trapped inside the PFO after the stroke. The first thrombus visualized probably arose from the venous system of the lower limbs and passed through a small ostium, giving us the exceptional opportunity to prove the stroke's cardioembolic etiology through a PFO in an elderly patient.</p><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of interest</span><p id="par0040" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:1 [ 0 => array:2 [ "identificador" => "sec0025" "titulo" => "Conflicts of interest" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2018-04-18" "fechaAceptado" => "2018-05-14" "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1163 "Ancho" => 2083 "Tamanyo" => 211496 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A – Transesophageal echocardiography (TEE) reveals the passage of a large thrombus through the patent foramen ovale, which later led to stroke. B – TEE shows a smaller thrombus following the initiation of unfractionated heparin. C – Transthoracic echocardiography reveals no thrombus.</p>" ] ] ] ] "idiomaDefecto" => "en" "url" => "/21742049/0000003800000005/v2_201911300820/S2174204919301552/v2_201911300820/en/main.assets" "Apartado" => array:4 [ "identificador" => "28321" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Image in Cardiology" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21742049/0000003800000005/v2_201911300820/S2174204919301552/v2_201911300820/en/main.pdf?idApp=UINPBA00004E&text.app=https://revportcardiol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204919301552?idApp=UINPBA00004E" ]
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