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            "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">&#40;A&#41; Right coronary artery &#40;RCA&#41; with important calcification and 50&#37; lesion in the mid third&#44; posterior descending artery &#40;PDA&#41; and right posterolateral artery &#40;RPLA&#41; with severe calcification and lesions of 80&#37; and 70&#37;&#59; respectively&#59; &#40;B&#41; left main &#40;LM&#41; with calcified lesions of 80&#37; in the distal third&#44; left anterior descending artery &#40;LAD&#41; with significant calcification and 90&#37; in the mid third&#44; and diagonal branches &#40;DG1 and DG2&#41; with calcified lesions of 70 and 80&#37;&#44; respectively&#46; The left circumflex is occluded and calcified&#46;</p>"
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          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">&#40;A&#41; Transthoracic echocardiogram &#40;TTE&#41; showing a partial loss of myocardial tissue in the mid segment of the interventricular septum&#59; &#40;B&#41; contrast-enhanced TTE revealing a serpentine route through the septum to a small contained cavity&#59; &#40;C&#41; three-dimensional TTE en face view of the half-moon shaped septal defect&#59; &#40;D&#41; thoracic computed tomography conducted three years before&#44; showing the partial ventricular septal defect&#46;</p>"
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 78-year-old female with hypertension&#44; atrial fibrillation &#40;AF&#41; and heart failure with preserved ejection fraction was admitted due to decompensated heart failure&#46; On examination there was evidence of pulmonary congestion and there were no heart murmurs&#46; The electrocardiogram showed AF rhythm with controlled ventricular response&#44; with no other significant changes&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">The transthoracic echocardiogram &#40;TTE&#41; revealed moderate biventricular hypertrophy with apical predominance and good systolic function&#46; A partial loss of myocardial tissue in the mid segment of the interventricular septum was noticed&#44; apparently without interventricular communication or left-to-right shunt on color Doppler &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>A&#41;&#46; Contrast-enhanced TTE showed a serpentine route through the septum to a small cavity contained within it &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>B&#41;&#46; Three-dimensional en face TTE views additionally clarified the half-moon shape of this defect and its movement during the cardiac cycle&#44; closing during systole and opening during diastole &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>C&#41;&#46; Thoracic computed tomography conducted three years before in another context showed that the septal defect was already present&#44; with similar characteristics &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>D&#41;&#46; Cardiac catheterization with oximetry and ventriculography was performed and interventricular shunt was excluded&#46; There was no coronary artery disease&#46; Cardiac magnetic resonance imaging was not possible due to lack of patient collaboration&#46; The patient was discharged under optimized medical therapy&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">Partial ventricular septal defects&#44; which are rarely reported&#44; are thought to be congenital or a consequence of myocardial infarction&#46; They have been termed &#8216;Pacman heart&#8217; due to the shape changes during the cardiac cycle&#44; becoming slit-like or absent during systole&#44; like an opening and closing mouth&#44; resembling the Pac-Man&#174; video game&#46; Related complications include conduction disturbances&#44; rupture and altered systolic function&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of interest</span><p id="par0020" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare&#46;</p></span></span>"
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