que se leu este artigo
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Cardiology</span>" "titulo" => "Left heart failure, a challenging diagnosis in cardiology" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "313" "paginaFinal" => "314" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Miryan Cassandra, Inês Almeida, Rogério Teixeira, Joana Trigo, Marco Costa, Lino Gonçalves" "autores" => array:6 [ 0 => array:4 [ "nombre" => "Miryan" "apellidos" => "Cassandra" "email" => array:1 [ 0 => "m.cassandra.soares@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" => "Inês" "apellidos" => "Almeida" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "Rogério" "apellidos" => "Teixeira" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 3 => array:3 [ "nombre" => "Joana" "apellidos" => "Trigo" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 4 => array:3 [ "nombre" => "Marco" "apellidos" => "Costa" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 5 => array:3 [ "nombre" => "Lino" "apellidos" => "Gonçalves" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Serviço de Cardiologia do Centro Hospitalar e Universitário de Coimbra – Hospital Geral, Faculdade de Medicina da Universidade de Coimbra, Coimbra, Portugal" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Serviço de Cardiologia do Centro Hospitalar de Trás-os-Montes e Alto Douro, EPE – Hospital de S. Pedro, Vila Real, Portugal" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Insuficiência cardíaca esquerda, um desafio diagnóstico em cardiologia" ] ] "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" => 459 "Ancho" => 1500 "Tamanyo" => 66093 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Fluoroscopy during percutaneous patent ductus arteriosus closure: left, a continuous flow can be seen from the aorta to the pulmonary artery (yellow arrow); center, during device placement (yellow arrow); right, after the procedure the device is properly positioned with no residual shunt (yellow arrow).</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Patent ductus arteriosus (PDA) is one of the most common congenital heart defects, and causes left ventricular volume overload. However, it is a rare finding among adults due to the lack of symptoms related to its small size, and it is not usually associated with other congenital lesions.</p><p id="par0010" class="elsevierStylePara elsevierViewall">A 53-year-old woman was referred for percutaneous closure of a PDA. She had undergone a secundum atrial septal defect (ASD) closure in 2007, detected after a cryptogenic stroke. After this procedure, her clinical history was remarkable for fatigue, dyspnea and orthopnea with New York Heart Association (NYHA) functional class III, and a continuous murmur was heard over the left sternal border. A routine transthoracic echocardiogram performed in 2013 revealed a continuous flow from the aorta towards the pulmonary artery, with left-sided chamber dilation (ejection fraction 50%) and normal pulmonary artery pressure. The device previously implanted at the atrial septum was correctly positioned and without residual shunt (<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>). The PDA was closed by placing an Amplatzer™ Duct Occluder guided by fluoroscopy and intracardiac echocardiography (<a class="elsevierStyleCrossRef" href="#fig0010">Figure 2</a>). The procedure was uneventful. The 12-month follow-up showed significant clinical improvement (NYHA functional class II), no residual shunt, and normal left chamber dimensions (<a class="elsevierStyleCrossRef" href="#fig0015">Figure 3</a>).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">In this case, the association with an ASD may have delayed the clinical manifestations of the PDA, as the previous left-to-right shunt probably compensated for the left ventricular volume overload. It is crucial to perform a complete high-quality echocardiogram in such patients with congenital heart disease, in order to screen for associated anomalies.</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="par0020" 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="par0025" class="elsevierStylePara elsevierViewall">The authors declare that no patient data appear in this article.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Right to privacy and informed consent</span><p id="par0030" class="elsevierStylePara elsevierViewall">The authors declare that no patient data appear in this article.</p></span></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conflicts of interest</span><p id="par0035" 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" => "sec0025" "titulo" => "Conflicts of interest" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2015-07-22" "fechaAceptado" => "2015-11-21" "multimedia" => array:3 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 639 "Ancho" => 956 "Tamanyo" => 88538 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Transthoracic echocardiogram (parasternal short-axis view): color Doppler displays a continuous turbulent flow from the aorta to the left branch of the pulmonary artery, consistent with a patent ductus arteriosus.</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 459 "Ancho" => 1500 "Tamanyo" => 66093 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Fluoroscopy during percutaneous patent ductus arteriosus closure: left, a continuous flow can be seen from the aorta to the pulmonary artery (yellow arrow); center, during device placement (yellow arrow); right, after the procedure the device is properly positioned with no residual shunt (yellow arrow).</p>" ] ] 2 => array:7 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 433 "Ancho" => 1300 "Tamanyo" => 81168 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Transthoracic echocardiogram after patent ductus arteriosus closure (parasternal short-axis view): left, an image consistent with the closure device (yellow arrow); right, on color Doppler the turbulent flow is no longer seen.</p>" ] ] ] ] "idiomaDefecto" => "en" "url" => "/08702551/0000003500000005/v3_201702080059/S0870255116300087/v3_201702080059/en/main.assets" "Apartado" => array:4 [ "identificador" => "29264" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Imagens em Cardiologia" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/08702551/0000003500000005/v3_201702080059/S0870255116300087/v3_201702080059/en/main.pdf?idApp=UINPBA00004E&text.app=https://revportcardiol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255116300087?idApp=UINPBA00004E" ]
Ano/Mês | Html | Total | |
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2023 Setembro | 28 | 19 | 47 |
2023 Agosto | 33 | 18 | 51 |
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2023 Maio | 46 | 24 | 70 |
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2023 Maro | 34 | 17 | 51 |
2023 Fevereiro | 37 | 19 | 56 |
2023 Janeiro | 20 | 13 | 33 |
2022 Dezembro | 29 | 22 | 51 |
2022 Novembro | 57 | 25 | 82 |
2022 Outubro | 40 | 23 | 63 |
2022 Setembro | 33 | 32 | 65 |
2022 Agosto | 39 | 36 | 75 |
2022 Julho | 35 | 32 | 67 |
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2022 Maio | 30 | 31 | 61 |
2022 Abril | 31 | 37 | 68 |
2022 Maro | 32 | 44 | 76 |
2022 Fevereiro | 32 | 38 | 70 |
2022 Janeiro | 41 | 43 | 84 |
2021 Dezembro | 24 | 33 | 57 |
2021 Novembro | 38 | 42 | 80 |
2021 Outubro | 39 | 40 | 79 |
2021 Setembro | 29 | 34 | 63 |
2021 Agosto | 34 | 34 | 68 |
2021 Julho | 16 | 20 | 36 |
2021 Junho | 25 | 21 | 46 |
2021 Maio | 31 | 39 | 70 |
2021 Abril | 78 | 45 | 123 |
2021 Maro | 82 | 20 | 102 |
2021 Fevereiro | 72 | 12 | 84 |
2021 Janeiro | 31 | 19 | 50 |
2020 Dezembro | 28 | 15 | 43 |
2020 Novembro | 30 | 18 | 48 |
2020 Outubro | 18 | 18 | 36 |
2020 Setembro | 43 | 15 | 58 |
2020 Agosto | 22 | 8 | 30 |
2020 Julho | 39 | 11 | 50 |
2020 Junho | 35 | 6 | 41 |
2020 Maio | 30 | 4 | 34 |
2020 Abril | 28 | 13 | 41 |
2020 Maro | 44 | 10 | 54 |
2020 Fevereiro | 83 | 48 | 131 |
2020 Janeiro | 21 | 7 | 28 |
2019 Dezembro | 37 | 8 | 45 |
2019 Novembro | 29 | 9 | 38 |
2019 Outubro | 25 | 3 | 28 |
2019 Setembro | 16 | 6 | 22 |
2019 Agosto | 35 | 13 | 48 |
2019 Julho | 37 | 11 | 48 |
2019 Junho | 36 | 10 | 46 |
2019 Maio | 30 | 12 | 42 |
2019 Abril | 33 | 15 | 48 |
2019 Maro | 37 | 17 | 54 |
2019 Fevereiro | 61 | 12 | 73 |
2019 Janeiro | 38 | 6 | 44 |
2018 Dezembro | 41 | 14 | 55 |
2018 Novembro | 62 | 12 | 74 |
2018 Outubro | 149 | 10 | 159 |
2018 Setembro | 28 | 7 | 35 |
2018 Agosto | 36 | 13 | 49 |
2018 Julho | 23 | 6 | 29 |
2018 Junho | 30 | 5 | 35 |
2018 Maio | 44 | 10 | 54 |
2018 Abril | 44 | 6 | 50 |
2018 Maro | 60 | 8 | 68 |
2018 Fevereiro | 30 | 7 | 37 |
2018 Janeiro | 39 | 9 | 48 |
2017 Dezembro | 46 | 10 | 56 |
2017 Novembro | 37 | 7 | 44 |
2017 Outubro | 23 | 6 | 29 |
2017 Setembro | 20 | 2 | 22 |
2017 Agosto | 20 | 10 | 30 |
2017 Julho | 26 | 10 | 36 |
2017 Junho | 22 | 9 | 31 |
2017 Maio | 21 | 14 | 35 |
2017 Abril | 13 | 7 | 20 |
2017 Maro | 23 | 12 | 35 |
2017 Fevereiro | 17 | 3 | 20 |
2017 Janeiro | 18 | 5 | 23 |
2016 Dezembro | 21 | 17 | 38 |
2016 Novembro | 18 | 14 | 32 |
2016 Outubro | 21 | 28 | 49 |
2016 Setembro | 15 | 12 | 27 |
2016 Agosto | 12 | 22 | 34 |
2016 Julho | 11 | 17 | 28 |
2016 Junho | 4 | 58 | 62 |
2016 Maio | 2 | 87 | 89 |